Intraoperative stretching microbreaks reduce surgery-related musculoskeletal pain in otolaryngologists

Elzomor, Amir; Tunkel, Alexandra; Lee, Esther; Jaamour, Farris; Davidson, Lauren; Shaver, Timothy Brandon; Niermeyer, Weston; Benito, Daniel A.; Cole, K. D.; Zapanta, Philip E.

doi:10.1016/j.amjoto.2022.103594

Cited by 7 publications

(4 citation statements)

References 31 publications

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“… 3 , 12 , 13 However, interventions such as resident ergonomic teaching programs and intraoperative breaks have shown promise in improving intraoperative ergonomic positioning, and if habitually implemented among trainees, may result in improved musculoskeletal outcomes among trainee otolaryngologists. 14 , 15 …”

Section: Discussionmentioning

confidence: 99%

Ergonomics of Various Modalities for Ear Surgery

Lin,

Zhou,

Kakeheta

et al. 2024

OTO Open

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ObjectiveEvaluate ergonomic differences of various modalities for performing middle ear surgery.Study DesignObservational study.SettingTwo academic tertiary care centers.MethodsAttending physicians and residents performing middle ear surgery were photographed intraoperatively. Intraoperative photographs were analyzed using the validated Rapid Upper Limb Assessment (RULA) tool to measure musculoskeletal disease (MSD) risk. Descriptive statistics and significance testing were used to characterize and compare ergonomic differences between surgical modalities. Multivariable ordinal regression was performed to assess factors associated with increased MSD risk, as determined by the final RULA score.ResultsMost of our 110 intraoperative photos featured attendings (82.7%) performing combined middle ear surgery and mastoidectomy (60.0%). Body angles and the final RULA score varied significantly among modalities. On subset analysis, microscopic surgery exhibited significantly worse wrist, trunk, and neck angles compared to endoscopic and exoscopic surgery. Exoscopic surgery had significantly lower final RULA scores than both endoscopic and microscopic surgery, indicating significantly lower MSD risk. Microscopic and endoscopic surgery final scores did not vary significantly. In a multivariable ordinal regression of factors associated with increased RULA score, exoscopic surgery had statistically significantly less ergonomic risk relative to microscopic surgery (odds ratio = 0.12, 95% confidence interval = [0.03‐0.43]).ConclusionExoscopic, endoscopic, and microscopic surgery all featured low ergonomic risk, although exoscopic middle ear surgery demonstrated the lowest risk profile among studied surgical modalities. This demonstrates the importance of using each modality in combination with other ergonomic interventions to provide meaningful musculoskeletal benefits.

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Section: Discussionmentioning

confidence: 99%

Ergonomics of Various Modalities for Ear Surgery

Lin,

Zhou,

Kakeheta

et al. 2024

OTO Open

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“…However, the surgeon's position during surgery is not the only element responsible for producing changes in the musculoskeletal system, and various authors have studied other factors. So, other recommendations that orthopaedic surgeons should know and apply are to take microbreaks of 30-90 s every 20-40 min of work, as the literature suggests that these reduce the incidence of musculoskeletal disorders and increase concentration, improving performance without significantly increasing surgical time [26,27]. On the other hand, several studies propose specific physical training programmes for strength, endurance, and flexibility to reduce musculoskeletal disorders resulting from surgical work in different specialities [22,28,29].…”

Section: Discussionmentioning

confidence: 99%

Ergonomic Evaluation of Different Surgeon Positions for Total Knee Arthroplasty Surgery

Sánchez-Robles,

Díaz-Martínez,

León-Muñoz

et al. 2023

Applied Sciences

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Ergonomics and risk factors for work-related musculoskeletal disorders have been studied extensively in various industry fields. However, only a few decades ago, these issues became a concern in the healthcare sector. Total knee arthroplasty (TKA) is one of the most common procedures performed by orthopaedic surgeons, and it would be desirable to perform it with an ergonomically safer technique. This study evaluated the ergonomic risk of different surgeon positions when performing contralateral TKA using the dominant hand. After the authors defined the four possible surgeon positions according to the most common positions used by surgeons in our environment (position A, on the opposite side of the knee to be operated on; position B, on the same side as the knee to be operated on; position C, with the patient’s legs separated and the surgeon standing between them; and position D, facing the knee to be operated on, at the patient’s feet), we performed an ergonomic analysis using the Rapid Entire Body Assessment (REBA) method. The overall REBA scores (lower score values indicate better ergonomics than higher) were between 7 and 6.5 for position A, between 6.17 and 5.5 for position B, between 5.92 and 5.5 for position C, and between 3.75 and 3.42 for position D. The test–retest and inter-rater reliability values ranged from substantial agreement to almost perfect agreement. Based on the results, we can conclude that the most ergonomic position for a right-handed surgeon to perform a left TKA is facing the left knee, at the patient’s feet (position D).

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“…Several solutions have been proposed to reduce MSK problems. Such solutions range from very simple guidelines to complex, time‐consuming, expensive devices 20–24 . Surgical procedures in otolaryngology are extremely varied, and likely benefit from a variety of solutions.…”

Section: Introductionmentioning

confidence: 99%

“…Such solutions range from very simple guidelines to complex, time-consuming, expensive devices. [20][21][22][23][24] Surgical procedures in otolaryngology are extremely varied, and likely benefit from a variety of solutions. These include ergonomic chairs, wrist rests, surgical robots or endoscope holders.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of an Exoskeleton Armrest to Improve Ergonomics during Endoscopic Sinus and Skull Base Surgery

Lobo,

Sancibrian,

Mesones

et al. 2023

The Laryngoscope

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ObjectiveThe main objective of this study was to develop and evaluate the feasibility and effectiveness of a novel exoskeleton system designed to provide ergonomic assistance to surgeons while preserving or improving the quality of endoscopic sinus and skull base surgical procedures.MethodsTo evaluate the functionality and ergonomic characteristics of the device, five experiments were conducted in different and increasingly realistic scenarios: silicone model of the nasal cavity, freshly frozen cadavers and finally in a real surgery. Each volunteer's task was recorded and timed. The National Aeronautics and Space Administration Task Load Index (NASA‐TLX) rating scale was used to estimate the surgeons' workload while performing the tasks.ResultsTwenty‐five volunteers took part in the experiments. Volunteers perceived more comfort and less fatigue and pain when using the armrest than when not using the device (3.3, SD 1.75 vs. 5.9 SD 1.49; p = 0.02). Participants found the device intuitive, comfortable, and improving accuracy and stability with endoscope use.ConclusionA new system that provides ergonomic assistance to surgeons was tested in simulation surgery with acceptable usability. Initial results in terms of pain and fatigue reduction and efficiency were excellent, justifying further research into this technology.Level of EvidenceN/A Laryngoscope, 2023

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Intraoperative stretching microbreaks reduce surgery-related musculoskeletal pain in otolaryngologists

Cited by 7 publications

References 31 publications

Ergonomics of Various Modalities for Ear Surgery

Ergonomics of Various Modalities for Ear Surgery

Ergonomic Evaluation of Different Surgeon Positions for Total Knee Arthroplasty Surgery

Feasibility of an Exoskeleton Armrest to Improve Ergonomics during Endoscopic Sinus and Skull Base Surgery

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