Intraoperative musculoskeletal discomfort and risk for surgeons during open and laparoscopic surgery

Yang, Liyun; Wang, Tianke; Weidner, Tiffany K.; Madura, James A.; Morrow, Melissa M.; Hallbeck, M. Susan

doi:10.1007/s00464-020-08085-3

Cited by 32 publications

(21 citation statements)

References 52 publications

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“…The most frequent answers included laparoscopic procedures, long procedures (procedures that lasted over an hour), and open surgeries. The association of pain with laparoscopic procedures causing pain has been documented previously, and this study confirms those findings, with no difference reported between genders 1 , 5 , 16 Furthermore, longer open surgeries tend to promote poorer ergonomics for longer periods of time, leading to more injury, which is also consistent with previous literature 1 – 5 , 9 – 21…”

Section: Discussionsupporting

confidence: 92%

“…A growing awareness is emerging of the high-risk postures maintained while surgeons spend long strenuous hours operating and the risk of subsequent musculoskeletal injury. 1 There is an unsatisfied demand for education on optimal ergonomics during operations to help mitigate against these types of injuries. 2 This lack of awareness and education has resulted in a high prevalence of musculoskeletal pain and injury that can affect the head, neck, shoulder, wrist, hand, and back.…”

Section: Introductionmentioning

confidence: 99%

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Operation-related Musculoskeletal Injuries among United States Surgeons: A Gender-stratified National Survey

Tran

Kortz

Johnson

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Operation-related musculoskeletal injury (ORMI) among surgeons is a well-described phenomenon. Our study aimed to determine the prevalence of self-reported ORMI among surgeons of various subspecialties and preliminarily investigate the role of gender. Methods: An anonymous survey, querying information pertinent to ORMIs, was distributed online through the American College of Surgeons community membership forum. Nonparametric univariate analysis and a multivariate regression model were conducted. A P value of 0.05 determined significance. Results: A total of 624 male and female surgeons responded to the survey, with 50.8% reporting having an injury related to operating. Among the entire cohort, the prevalence of ORMI was significantly higher among female surgeons than male surgeons (P = 0.01), although there was no significant difference among the genders in ORMI prevalence when stratifying by age group (all P > 0.05). Conclusion: Female surgeons are more likely to report an ORMI, although the impact of confounding variables such as age, operative case volume, and surgical subspecialty remain to be fully elucidated.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Operation-related Musculoskeletal Injuries among United States Surgeons: A Gender-stratified National Survey

Tran

Kortz

Johnson

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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“…These results show that the DIEP flap surgery is a high workload/demand procedure for residents. The results obtained for mental demand, physical demand, distraction, and difficulty were consistent with responses from attending surgeons for surgeries of around 2-4 hours (scrub-in to scrubout time) (Yang, 2020).…”

Section: Discussionsupporting

confidence: 76%

Correlation between workload and teamwork among residents in DIEP Flap surgery

Norasi

Wang

Law

et al. 2021

Proceedings of the Human Factors and Ergonomics Society Annual

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The goal of this study was to evaluate residents’ workload and teamwork and the correlation between their workload and teamwork subscales during deep inferior epigastric perforator (DIEP) flap surgery. Ten residents who assisted during DIEP flap procedures completed an electronic survey following each DIEP flap procedure from July 2019 to August 2020. The survey contained items from the NASA-TLX and SURG-TLX and questions to measure teamwork subscales. Across 29 surgical cases, 38 surveys were recorded. Overall, the means of workload subscales were mostly greater than 10 and less than 15 (range=020) and the means of all teamwork subscales were greater than 15 (range=0-20). Good teamwork was correlated with lower distractions (Rs= -0.36 to -0.48) and better performance (Rs=0.35 to 0.52). Also, all the teamwork subscales were highly correlated (Rs= 0.59 to 0.92). Our findings suggest that good teamwork, low distractions, and successful performance are generally observed together; however, a causative relationship could not be established based on these results.

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“…Exclusion of these 12 trials may have precluded certain comparisons from achieving significance. Although the majority of the musculoskeletal literature has centered around back and neck discomfort, [49][50][51][52] it is possible the pain reported by surgeons within our cohort was derived from joint angles or body portions not analyzed by the present study. Lastly, as subjects were outfitted with sensors, participants may have been subject to the Hawthorne effect, where participants' awareness of the sensors resulted in more vigilant or altered posture.…”

Section: Discussionmentioning

confidence: 99%

Ergonomic Analysis of Functional Endoscopic Sinus Surgery Using Novel Inertial Sensors

et al. 2021

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Objectives/Hypothesis Suboptimal ergonomics during endoscopic sinus surgery can lead to considerable physical discomfort and fatigue for the surgeon. The purpose of this pilot study is to objectively evaluate the ergonomic positions of trainee and attending surgeons while performing functional endoscopic sinus surgery (FESS). Study Design Pilot prospective trial. Methods Six surgeons (two attendings and four trainees) performed FESS while wearing 11 inertial measurement units (IMUs) affixed to either side of each major joint. Screen placement was standardized to be 1 m directly in front of the surgeon and on the patient's left, 0–15° declined from the surgeons' eyes. Bed height was standardized such that the workspace was 0 to 10 cm below the elbows. IMU data were analyzed to calculate joint angles. Ideal joint angles (i.e., <10° for neck and trunk) were determined by the validated Rapid Entire Body Assessment tool. Subjects subsequently completed a modified National Aeronautics and Space Administration Task Load Index to assess cognitive and physical burden and pain. Student's t‐test was employed to detect differences between groups. Results Trainees adopted positions involving significantly greater neck flexion (9.90° vs. −6.48°, P = .03) and reported significantly higher frustration levels (3.04 vs. 1.33, P = .02) while operating than attendings. For both cohorts, increased operative time was significantly correlated with greater back flexion (r = 0.90, P = .02; r = 0.55, P = .04, respectively). Conclusions Our data suggest that trainees operate with higher risk neck postures than do attendings. These data indicate high‐risk operative postures may be borne of inexperience and present an opportunity for postural interventions at an early stage of training. Level of Evidence NA Laryngoscope, 132:1153–1159, 2022

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Intraoperative musculoskeletal discomfort and risk for surgeons during open and laparoscopic surgery

Cited by 32 publications

References 52 publications

Operation-related Musculoskeletal Injuries among United States Surgeons: A Gender-stratified National Survey

Operation-related Musculoskeletal Injuries among United States Surgeons: A Gender-stratified National Survey

Correlation between workload and teamwork among residents in DIEP Flap surgery

Ergonomic Analysis of Functional Endoscopic Sinus Surgery Using Novel Inertial Sensors

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