Operating hurts: a study of EAES surgeons

Abstract

Background Work-related pain and discomfort experienced by surgeons is widely reported in the literature. A survey was, therefore, conducted to explore this issue among members of the European Association for Endoscopic Surgery (EAES). Methods The survey was emailed to 2980 EAES members in 2017 enquiring about their working practice, musculoskeletal (MSK) pain and burnout. Results A total of 569 (19%) surgeons responded, of whom 556 were practicing surgeons; 86% were consultants, 84% were male, and 94% were right-handed. Respondents operated on average 3.3 days/week with 27% of their procedures lasting longer than 3 h. The 386 endoscopists surveyed reported performing an average of 5.3 procedures/day with 83% performing endoscopy at least once per week. Over half of practicing surgeons (62%) reported their worst pain score was 3 or higher (10-point scale) in the past 7 working days, encompassing 71% of their open, 72% laparoscopic, 48% robot-assisted cases and 52% of their endoscopies. Of the 120 surgeons who had ever sought medical help for aches, pain or discomfort, 38% were currently in pain and 16% had considered leaving surgery due to their MSK pain, 26% had reported work-related pain to their employer, 26% had been on short-term disability during their career and 4% long-term disability due to MSK disorders. A significant proportion of the respondents (49%) felt their physical discomfort would influence the ability to perform or assist with surgical procedures in the future. These surgeons reported significantly lower satisfaction from their work ( p = 0.024), higher burnout ( p = 0.005) and significantly higher callousness toward people ( p < 0.001) than those not fearing loss of career longevity. Conclusion The results show that MSK pain is prevalent amongst EAES members. Nearly half the respondents had career longevity fears from pain/discomfort which, in turn, correlated with more prevalent feelings of burnout. More emphasis should be placed on the aetiology, prevention and management of musculoskeletal pain in the surgical workforce.

Impact of Procedure Type, Case Duration, and Adjunctive Equipment on Surgeon Intraoperative Musculoskeletal Discomfort

“…[1][2][3][4][5][6][7][8] WMSDs can lead to impaired surgical well-being, leading to higher surgeon disability, decreased quality of life, and reduced career longevity. [8][9][10][11] WMSDs can also lead to reduced patient safety, reduced quality of surgical care, and overall reduced functioning of the surgical healthcare system, which incurs great patient and societal costs. [12][13][14][15] Research efforts to improve surgical ergonomics have been underway during the past 2 decades.…”

Ergonomic Challenges in the Perioperative Setting

“…Only the 2003 study of the general nursing workforce 15 and the QI project were completed in the United States 16 . Three studies were conducted in Iran; 17,19 two in the Netherlands; 20,21 and the others in Egypt, 22 Europe, 23 Germany, 24 Israel, 25 Sweden, 26 and Turkey 27 …”

“…Researchers used a variety of data collection methods, including survey, 15,16,20,23,24,25 survey with a physical examination, 26 survey with an observation, 17-19 survey with an observation and a skills checklist, 22 survey with observations and interviews, 21 and observations 27 …”

“…Some recent literature addressed the ergonomic risks that surgeons face in the OR, 23,28,29 and multiple studies included perioperative personnel 16‐22,24‐27 . However, few of the studies we reviewed focused on perioperative nurses, 17,18,22 and one study conducted in the Netherlands focused on operating assistants— non‐nurse team members who functioned in the circulator, scrub person, and first assistant roles 20 .…”

Workload Differentiates Breast Surgical Procedures: NSM Associated with Higher Workload Demand than SSM

“…13 Several studies have also found approximately 50% of surgeons fear they will have a shortened career due to musculoskeletal disorders, with a significant correlation between this fear of a shortened career and burnout. 14,15 Jackson and colleagues employed NASA-TLX and SURG-TLX questions to ask breast surgeons to compare nipple-sparing mastectomy and skin-sparing mastectomy, finding that surgeons reported greater physical symptoms, mental strain, and fatigue with nipple-sparing mastectomy than skin-sparing mastectomy. 16 Together, these findings raise concern that discomfort along with increased cognitive and technical demand over the course of a breast surgeon's career may lead to musculoskeletal disorders and burnout and ultimately shorten surgical careers.…”