Ergonomics and musculoskeletal symptoms in surgeons performing endoscopic procedures for benign prostatic hyperplasia

Abstract

Background and purpose: Benign prostatic hyperplasia (BPH) is the most common urologic disorder affecting older men, necessitating medical or surgical intervention. Limited data exists regarding the effect these surgeries have on the endourologist’s musculoskeletal system following the surgery because of the required difficult posture, prolonged procedures, repetitive movements, and the settings of an adjustable visual display terminal workstation. The aim of our study was to survey the prevalence and possible causes of musculoskeletal disorders among endourologists performing transurethral resection of the prostate (TURP) or laser prostatectomy using either holmium laser enucleation or thulium laser enucleation. Materials and methods: An email inviting all members of the Endourological Society to participate in the survey was sent. The questionnaire included different demographic and practice characteristics, with concern regarding performing either TURP or laser prostatectomy and the incidence and type of musculoskeletal incidents following these surgeries. All responses were collected by a commercially available internet based survey host ( www.surveymonkey.com ) over a period of 6 weeks. Results: Of the 121 complete responses, 84 (69%) of endourologists complained of a musculoskeletal disorder following TURP or laser prostatectomy. The most frequent complaint was for neck (64%), followed by back (57%), shoulder (48%), hand (40%), and elbow (18%). The average prostate volume turned out to be the most compelling predictor for musculoskeletal disorder occurrence with an average prostate volume of 76 g operated on by the complaining group compared with 59 g in the noncomplaining group. Those with more severe symptoms were linked to a mean prostate size of 80 g (60–146) and constantly complained of shoulder, neck, or back trouble compared with the less-severely complaining group. Conclusions: A high prevalence of musculoskeletal complaints among urologists performing endourologic prostatectomy was confirmed and was found to be proportionally related to the size of the prostate. The integration of an ergonomic specialist inside the operation room to watch and correct the surgeon’s position during endourologic procedures may reduce the endourologist’s exposure to these occupational hazards.

Robot-assisted flexible ureterorenoscopy: state of the art in 2022

“…The novices completed the tasks more quickly and with a lower workload when using robotic manipulation, whereas the experts showed the opposite trend. The learning rate in all groups was greater for robotic manipulation (21.02% on average) than for conventional manipulation (13.75%) [32,33] .…”

“…This robotic catheter system was modified and equipped with a fiber endoscope and a customized ureteral catheter to perform ureteroscopy with the commercial master device Omega 3 (Force Dimension, Switzerland), although the existing drawbacks of inappropriate control mode and inadequate working range partially contributed to the termination and eventual failure of this project [22,26,27] . Kwon et al [32,33] 2022 easyEndo robotic endoscopy system (EasyUretero) Phantom None…”

Employment-related musculoskeletal complications experienced by the physical therapists in Bangladesh: a comprehensive cross-sectional case study

“…Omar et al showed normal weight and overweight participants are more commonly affected in work-related musculoskeletal disorders among surgeons [39]. Singh et al also stated in their research those normal-weight participants are most vulnerable to work-related musculoskeletal disorders [40].…”

Laser eyewear: broadening the focus on eye safety in endourology

“…Suboptimal ergonomics significantly impacts urologists' health, contributing to musculoskeletal injuries, burn‐out and early retirement. Endoscopic surgery is maximally burdensome 22 . Although the effect of laser goggles on surgical ergonomics has not been directly evaluated, experience tells us that ill‐fitting eyewear frequently requiring readjustment is likely to negatively impact surgeons, affecting positioning, comfort and visibility.…”

“…Endoscopic surgery is maximally burdensome. 22 Although the effect of laser goggles on surgical ergonomics has not been directly evaluated, experience tells us that ill-fitting eyewear frequently requiring readjustment is likely to negatively impact surgeons, affecting positioning, comfort and visibility. Operative ergonomics has been identified as a key target to improve career longevity and reduce burnout in the United States, where urology workforce shortages loom.…”