Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons

Abstract

Background: This study aimed to obtain an answer for the question: Are ergonomic guidelines applied in the operating room and what are the consequences? Methods: A total of 1,292 questionnaires were sent by email or handed out to surgeons and residents. The subjects worked mainly in Europe, performing laparoscopic and/or thoracoscopic procedures within the digestive, thoracic, urologic, gynecologic, and pediatric disciplines. Results: In response, 22% of the questionnaires were returned. Overall, the respondents reported discomfort in the neck, shoulders, and back (almost 80%). There was not one specific cause for the physical discomfort. In addition, 89% of the 284 respondents were unaware of ergonomic guidelines, although 100% stated that they find ergonomics important. Conclusion:The lack of ergonomic guidelines awareness is a major problem that poses a tough position for ergonomics in the operating room.

Video-assisted surgery: suggestions for failure prevention in laparoscopic cholecystectomy

“…However, adding a specific preparation phase to the instructions which highlight the meaning of working principles in the beginning of the procedure description before placing trocars, could be beneficial. This is supported by the prior studies arguing that the majority of surgeons and residents are unaware of ergonomic practices and guidelines, even though they realize the importance of ergonomics during video-assisted operations (Gawande 2003;Wauben et al 2006). Ergonomics and environmental factors have proven critical in avoiding fatigue, concentration problems and human errors in OT and the ergonomics of training setting greatly influence both task performance and skills learning at least in simulated operating settings (Emam et al 2002;Xiao et al 2012).…”

Is there an Increased Incidence of Cervical Degenerative Disease in Surgeons who use Loupes and a Headlight?

“…Other studies support the theory that when the head is held in a fixed, flexed position, increased stresses are generated that may produce symptoms of neck pain [1,5,9]. Younger patients with chronic nontraumatic neck pain, and without age-related spondylotic changes, were shown to have a more forward head posture in standing than matched pain-free participants in one study [10].…”

“…70% of surgeons in this study agreed that bad monitor positioning led to the development of neck symptoms [1]. Further, cervical biomechanical studies demonstrate that, in a neutral, lordotic spine, axial loads are dispersed through an instantaneous axis of rotation (IAR) centered within the vertebral bodies without any torsion or moment arms applied to cervical discs [11].…”

“…Up to 70% of surgeons who perform endoscopic surgery experience neck, shoulder, or back pain associated with improper table height or monitor positioning [1]. In one study, 67% of the evaluated operating rooms for endoscopic surgery had poor ergonomic conditions [2].…”

Initial experience of a novel ergonomic surgical chair for laparoscopic pelvic surgery

“…Posture during standing thus forms an inverted pendulum, appearing to be static but actually under dynamic control (4). Neck and shoulder pain have been exhibited by laparoscopic surgeons' and their posture (5,6). In an assessment of fatigue of laparoscopic surgeons, the static contraction of the upper trapezius, middle trapezius, lower erector spinai, and hamstrings exceeded maximal voluntary isometric contraction threshold limits for a fatigue response.…”