Surgical ergonomics for urologists: a practical guide

Gabrielson, Andrew; Clifton, Marisa M.; Pavlovich, Christian P.; Biles, Michael J.; Huang, Mitchell M.; Agnew, Jacqueline; Pierorazio, Phillip M.; Matlaga, Brian R.; Bajic, Petar; Schwen, Zeyad

doi:10.1038/s41585-020-00414-4

Cited by 40 publications

(26 citation statements)

References 77 publications

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“…The ergonomics of the procedures for surgeons are often under-reported, and poor ergonomics affect physical, mental, and economic well-being. A greater degree of adverse ergonomic problems are expected among urologists who perform a wide range of operative procedures such as open, laparoscopic, robotic, endoscopic, and microscopic surgeries [57]. Catanzarite et al have shown that work-related musculoskeletal disorders are prevalent in 66% to 90%, 73% to 100%, and 23% to 80% for open, laparoscopic, and robotic surgeries, respectively [58].…”

Section: Ergonomicsmentioning

confidence: 99%

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Outcomes of Robotic Surgery for Low-Volume Surgeons

Panaiyadiyan¹,

Kumar²

2022

SIUJ

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When the outcomes are equivalent to the open technique, conventional laparoscopy is a preferred surgical approach because of its minimal invasiveness. However, outcomes following laparoscopy depend on the surgeon’s expertise, and there is a significant learning curve to attain efficiency in complex reconstructing laparoscopic procedures. Robotic assistance bridges the gap between open and laparoscopic procedures and allows surgeons with limited laparoscopy experience to offer the benefits of minimally invasive surgery to their patients. While existing data do not show better outcomes with robot assistance compared with laparoscopy for most procedures, these studies are based on data from high-volume surgeons and centers. In reality, a significant number of surgeries are performed by low-volume centers and surgeons, and robotic assistance may enable them to offer benefits of minimally invasive surgery equivalent to those of higher volume centers since robotic assistance is associated with a shorter learning curve than laparoscopy. We review the data on the outcomes of robotic surgery for low-volume surgeons with a focus on centers and surgeons in Asia.

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Section: Ergonomicsmentioning

confidence: 99%

“…For instance, one of the most common ergonomic issues while performing robotic surgery is abducted shoulder and not maintaining a right angle with the biceps, resulting in lifting off the elbows from the armrest. Surgeons have to use the clutch control to mitigate the abnormal posture [57].…”

Section: Ergonomicsmentioning

confidence: 99%

Outcomes of Robotic Surgery for Low-Volume Surgeons

Panaiyadiyan¹,

Kumar²

2022

SIUJ

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“…In a study by Elkoushy et al, 64% of endourologists reported orthopedic related discomfort, with greatest prevalence in endourologists 40 years of age and older who had practiced for >10 years. The most common complaints were back problems (38.1%), neck problems (27.6%), hand problems (17.2%), and (35,36).…”

Section: Improving Surgical Ergonomicsmentioning

confidence: 99%

“…The display monitors should be positioned directly in front of the surgeon at eye level to allow for <30 degrees of neck angulation and at a distance of 80-120 cm away. The upper body should be in a neutral position, with elbows bent between 90 and 120 degrees with the arms abducted no more than 30 degrees (35). A finger grip of the ureteroscope is preferable to a palm grip (36).…”

Section: Upper Bodymentioning

confidence: 99%

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Safety During Ureteroscopy: Radiation, Eyes, and Ergonomics

Miller

Semins

2021

Front. Surg.

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It is known that urologic surgeons are at risk of work-place injury due to the physical requirements of operating and exposure to hazards. These hazards include radiation, exposure to body fluids, use of laser energy, and orthopedic injury due to the physical nature of operating. The risks that these hazards present can be mitigated by implementing several evidence-based safety measures. The methods to protect against radiation exposure include keeping radiation usage in the operating room as low as reasonably achievable, donning lead aprons, and wearing protective glasses. Additionally, protective glasses decrease the risk of eye injury from laser injury and exposure to body fluids. Finally, practicing sound surgical ergonomics is essential to minimize the risk of orthopedic injury and promote career longevity. The interventions discussed herein are simple and easy to implement in one's daily practice of urology.

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Ergonomic risk assessment of surgeon's position during radical prostatectomy: Laparoscopic versus robotic approach

Hayashi,

Sarri,

Pereira

et al. 2023

Journal of Surgical Oncology

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Background and ObjectivesRadical prostatectomy (RP) is a definitive surgical therapy for localized prostate cancer. Evidence suggests that the poor ergonomics of surgeons during RP may lead to work‐related musculoskeletal disorders and loss of productivity. Since each surgery modality has its physical demands, we compared the ergonomic risk between laparoscopic (LRP) and robotic‐assisted (RARP) radical prostatectomy.MethodsThe study assessed the posture of 10 urological surgeons during LRP and RARP surgeries with the Rapid Entire Body Assessment (REBA) scale.ResultsWe found that the RARP approach resulted in lower REBA scores over the LRP procedure.ConclusionsRobotic surgery improves body posture for the urological surgeon like in other medical specialties. However, the surgeons display harmful postures in both surgeries.

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Surgical ergonomics for urologists: a practical guide

Cited by 40 publications

References 77 publications

Outcomes of Robotic Surgery for Low-Volume Surgeons

Outcomes of Robotic Surgery for Low-Volume Surgeons

Safety During Ureteroscopy: Radiation, Eyes, and Ergonomics

Ergonomic risk assessment of surgeon's position during radical prostatectomy: Laparoscopic versus robotic approach

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