Ergonomics in the operating room

Abstract

BackgroundSince the introduction of minimally invasive surgery, surgeons appear to be experiencing more occupational musculoskeletal injuries. The aim of this study is to investigate the current frequency and effects of occupational musculoskeletal injuries on work absence.MethodsAn online questionnaire was conducted among all surgeons affiliated to the Dutch Society for Endoscopic Surgery, Gastrointestinal Surgery, and Surgical Oncology. In addition, this survey was conducted among surgeons, gynaecologists, and urologists of one cluster of training hospitals in the Netherlands.ResultsThere were 127 respondents. Fifty-six surgeons currently suffer from musculoskeletal complaints, and 30 have previously suffered from musculoskeletal complaints with no current complaints. Frequently reported localizations were the neck (39.5 %), the erector spinae muscle (34.9 %), and the right deltoid muscle (18.6 %). Most of the musculoskeletal complaints were present while operating (41.8 %). Currently, 37.5 % uses medication and/or therapy to reduce complaints. Of surgeons with past complaints, 26.7 % required work leave and 40.0 % made intraoperative adjustments. More surgeons with a medical history of musculoskeletal complaints have current complaints (OR 6.1, 95 % CI 1.9–19.6). There were no significant differences between surgeons of different operating techniques in localizations and frequency of complaints, or work leave.ConclusionsDespite previous various ergonomic recommendations in the operating room, the current study demonstrated that musculoskeletal complaints and subsequent work absence are still present among surgeons, especially among surgeons with a positive medical history for musculoskeletal complaints. Even sick leave was necessary to fully recover. There were no significant differences in reported complaints between surgeons of different operating techniques. Almost half of the respondents with complaints made intraoperative ergonomic adjustments to prevent future complaints. The latter would be interesting for future research.

Ergonomics and Musculoskeletal Health of the Surgeon

“…68 Surgeons who suffer from a work-related injury may require an increased amount of sick leave, variations or limitations to their practice, temporary assignments to nonsurgical tasks, or early retirement. 4,19,69 Self-medication or analgesic usage may alleviate symptoms, but these treatment options do not target the underlying cause. The ultimate goal would be to recognize causative factors at early stages and employ countermeasures to minimize pain and disability while promoting career longevity.…”

Handheld Devices for Laparoscopic Surgery

“…The use of surgical ports creates a pivot point for the instruments in the body wall, which reduces the degrees of freedom (DoF) of the surgical instruments, from six (free motion) in conventional surgery to four in laparoscopic surgery, as illustrated in Figure 1. Besides, laparoscopic instruments suffer from ergonomically inadequate handle designs and inefficient transmission of force and tactile feedback from the handle to the instrument tip [1,2].…”

Head‐up display assisted endoscopic lumbar discectomy—A technical note

“…As a result of display positioning in MIS, these axes are often misaligned, resulting in an ergonomic disadvantage. Multiple studies have demonstrated that this is an unfortunate downside to MIS and may result in excessive surgeon fatigue, discomfort, and work‐related musculoskeletal injuries . That being said, it is not surprising that the majority of surgeon discomfort appears to center around the neck and shoulders .…”