Ergonomic Status of Laparoscopic Urologic Surgery: Survey Results from 241 Urologic Surgeons in China

Abstract

BackgroundThe prolonged and frequent use of laparoscopic equipment raises ergonomic risks that may cause physical distress for surgeons. We aimed to assess the prevalence of urologic surgeons’ physical distress associated with ergonomic problems in the operating room (OR) and their awareness of the ergonomic guidelines in China.MethodsA sample of 300 laparoscopic urologists in China was assessed using a questionnaire on demographic information, ergonomic issues in the OR, musculoskeletal symptoms, and awareness of the ergonomic guidelines for the OR.ResultsThere were 241 survey respondents (86.7%) with valid questionnaires. Among the respondents, only 43.6% placed the operating table at pubic height during the actual operation. The majority of the respondents (63.5%) used only one monitor during the procedure. Only 29.9% placed the monitor below the eye level. More than half of the respondents (50.6%) preferred to use manual control instead of the foot pedal. Most of the respondents (95.0%) never used the body support. The respondents experienced discomfort in the following regions, in ascending order: leg (21.6%), hand (30.3%), wrist (32.8%), shoulder (33.6%), back (53.1%), and neck (58.1%). The respondents with over 250 total operations experienced less discomfort than those with less than 250 total operations. Most of the respondents (84.6%) were unaware of the ergonomic guidelines. However, almost all of the respondents (98.3%) regarded the ergonomic guidelines to be important in the OR.ConclusionsMost of the laparoscopic urologists were not aware of the ergonomic guidelines for the OR; hence, they have been suffering from varying degrees of physical discomfort caused by ergonomic issues. There is an urgent need for education regarding ergonomic guidelines in the OR for laparoscopic urologists in China.

A saúde física e mental do profissional médico: uma revisão sistemática

“…The majority (83.3%) comprised cross-sectional studies. Within this type of methodology, the main issues addressed in the studies on physical health were musculoskeletal disorders (AUeRBACH et al, 2011;MeHRDAD;DeNNeRLeiN;MORDHeSiZADeH, 2012;RUiTeNBURG;FRiNGS-DReSeN;SLUiTeR, 2013;MOHSeNi-BANDPei et al, 2011;LiANG et al, 2013) and ophthalmologic health (MReNA et al, 2011;KRUPiNSKi;BeRBAUM, 2009 Rauchenzauner et al (2009) found that frequent stressing situations, sleep deficit, and deregulation of the circadian rhythm are causes of the incidence of cardiovascular diseases in this group of professionals. Before the manifestation of symptoms of cardiovascular diseases, after night shifts physicians presented an increase in the cardiac frequency, as well as the elevation of blood pressure, dysrhythmia, altered catecholamine secretion, and an increase of serum cholesterol, uric acid, and potassium.…”

“…The most common ergonomic risks reported were spending long periods standing, sitting, and neck in flexion. Liang et al (2013) found that the increase on the incidence of numbness, pain and stiffness in the neck, shoulders, back, and legs of urologist surgeons was related to the emergence of surgical techniques that are less invasive but ergonomically less favorable.…”

Ergonomic Challenges Encountered by Laparoscopic Surgeons, Surgical First Assistants, and Operating Room Nurses Involved in Minimally Invasive Surgeries by Using RULA Method

“…Based on some studies, more than half of the surgeons prefer to use manual control instead of the pedal because of its discomfort and consequences. Monitor's position is another major ergonomic factor leading to improper use of the pedal (1,25). Unfortunately, as some operating rooms in this study had only one monitor, first assistants and operating room nurses had to turn the monitor to have a good view.…”

Ergonomics in Laparoscopic Surgery

“…Questionnaires are another assessment tool that focuses on gathering information from a population of surgeons. Taking into account studies with at least 100 respondents, a survey to laparoscopic urologists in China concluded that most of them were not aware of the ergonomic guidelines for the OR [36]. Shoulder, neck, back, and hand pain and stiffness were reported as the main physical symptoms during laparoscopic procedures [36,37].…”