Ergonomics and Surgeon Comfort During Flexible Ureteroscopy

Abstract

The technological advancements of flexible ureteroscopy (FURS) and its accessories have resulted in broadening its indications to include the management of complex renal stones, with long operative time. The surgeon’s understanding about the ergonomics of the ureteroscopes and their cognizance of the operation theatre layout helps to improve their performance, including the surgical outcomes. This paper will describe the ergonomics that are involved in conducting FURS which in turn will aid in developing a more conducive surgical environment for the surgeon during the procedure, based on scientific literature review and expert opinions in high-volume centres. Proper surgeon position, well-arranged operation theatre layout, monitor and pedal position, anaesthesia type, and surgical team are important factors to decrease musculoskeletal strains for surgeons and increase work efficiency. Different types of flexible ureteroscope have different characters and knowing these special characters leads to better ergonomics during surgery. Robotic-assisted FURS have shown good safety and ergonomics in clinical application.

Isometric Arm Forces Exerted by Females at Different Levels of Physical Comfort and Their EEG Signatures

“…Recently, increasing attention in the field of human factors and ergonomics has been given to the theoretical models and practical meaning of comfort at work [1,2]. It has been observed that many ergonomic investigations have considered negative aspects of work, such as physical discomfort, illness, or musculoskeletal disorders [3].…”

Flexible ureteroscopy with novel flexible ureteral access sheath versus mini‐percutaneous nephrolithotomy for treatment of 2–3 cm renal stones

“…Second, this study did not analyze the ergonomic disparities between the two groups, which is one of the factors urologists take into account when selecting a surgical approach. 29 Thirdly, this study is a retrospective study conducted at a single center and includes a limited number of cases. Further investigation is necessary to validate the present findings by conducting prospective randomized trials and multicenter studies involving a larger patient cohort.…”

“…Firstly, the follow‐up period was short, possibly providing insufficient time to detect potential ureteral strictures using techniques such as NCCT. Second, this study did not analyze the ergonomic disparities between the two groups, which is one of the factors urologists take into account when selecting a surgical approach 29 . Thirdly, this study is a retrospective study conducted at a single center and includes a limited number of cases.…”

Ergonomics of bronchoscopy: good advice or a pain in the neck?

“…One of the most studied ergonomic models is the surgeon performing laparoscopic surgery [31,32]. Current literature explores ergonomic concepts such as optimal bed height, monitor placement, adjustable screen heights, screen sizes, image quality and standing mat technology, which have been associated with improved provider comfort [33][34][35][36][37][38][39][40].…”