Patient and physician positioning during anterior skull base surgery impacts physician ergonomics

Maniam, Pavithran; Lucocq, James; Gohil, Rohit; Lewis-Morgan, G.; Rokade, Ashok

doi:10.1080/02688697.2022.2078477

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…Multiple interventions have been proposed to help address poor surgical ergonomics. These include modifications to patient and surgeon positioning, increased training, and increased focus on ergonomics 3,33‐35 . A pilot study in general surgery found that surgical residents have poor knowledge of ergonomic principles and a high rate of musculoskeletal symptoms, but that a surgical ergonomic workshop helped to improve both ergonomic knowledge and musculoskeletal symptoms 4 .…”

Section: Discussionmentioning

confidence: 99%

“…These include modifications to patient and surgeon positioning, increased training, and increased focus on ergonomics. 3,[33][34][35] A pilot study in general surgery found that surgical residents have poor knowledge of ergonomic principles and a high rate of musculoskeletal symptoms, but that a surgical ergonomic workshop helped to improve both ergonomic knowledge and musculoskeletal symptoms. 4 However, the adoption of these practices has been underwhelming and inconsistent, likely as they require additional time and attention from already busy surgeons.…”

Section: Discussionmentioning

confidence: 99%

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Female Surgical Ergonomics in Otolaryngology: A National Survey Study

Morse,

Tai,

Harpel

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveTo assess the nature and impact surgical ergonomic challenges experienced by female otolaryngologists.Study DesignNational survey study.SettingFemale otolaryngology residents, fellows and attendings recruited via social media posting and email distribution.MethodsWe distributed a survey study to female otolaryngologists throughout the United States. The height and glove size of participants reporting difficulties with equipment and instruments were compared to those not reporting difficulties.ResultsNinety‐six female otolaryngologists participated in our study, comprised of 43% residents, 10% fellows, and 47% attendings. Ninety percent of participants reported difficulties using equipment and 77% of participants reported difficulty with instruments, the most common being nasal endoscopic instruments (28%). The vast majority of participants reported pain during and (or) after the operation (92%). Head and neck (53%) and rhinology (44%) were identified as particularly challenging specialities, but only 25% of participants reported that ergonomics affected their career plans. Participants felt that adjustable equipment (60%), a variety of sizes of instruments (43%), and more discussion around ergonomics (47%) would help. Respondents reported adjusting the operating room to accommodate their size took extra time (44%) and was a mental burden (39%). Participants reporting difficulties with operating room equipment were significantly shorter than those without difficulties (64 inches vs 67 inches, P = .037), and those reporting difficulties with instruments had a smaller median glove size (6 vs 6.5, P = .018).ConclusionSurgical ergonomics represent a challenge for female otolaryngologists, particularly those with smaller hands and shorter height. Partnering with industry, we must address the needs of an increasingly diverse workforce to ensure that all surgeons can operate effectively and comfortably.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Female Surgical Ergonomics in Otolaryngology: A National Survey Study

Morse,

Tai,

Harpel

et al. 2023

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

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“…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%

“…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%

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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Work‐Related Musculoskeletal Disorders in Endoscopic Sinus and Skull Base Surgery: A Systematic Review With Meta‐analysis

Campbell,

Zadro,

Gamble

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveEndoscopic sinus and skull base surgery has led to significant improvements in patient outcomes, yet may have come at a cost to surgeons' musculoskeletal (MSK) health. We aimed to determine the prevalence and characteristics of work‐related MSK disorders (WRMDs) in endoscopic sinus and skull base surgeons; to investigate contributing factors for WRMD in this population; and to evaluate the effectiveness of ergonomic interventions on the severity or prevalence of WRMD in this population.Data SourcesMedline, Embase, CINAHL, Web of Science, and Scopus from inception to April 2, 2024. A bibliographic examination was performed for further papers.Review MethodsInclusion criteria included original peer‐reviewed papers with work‐related MSK outcomes (prevalence, contributing factors, and interventions) relating to endoscopic sinus and/or skull base surgeons in any language.ResultsOf 25,772 unique citations, 37 studies met the inclusion criteria. The pooled lifetime, point, and 12‐month prevalences of WRMD were 75.9% (95% confidence interval; I2, 67.2%‐83.6%, I2 95.6%), 80.8% (77.0%‐84.3%, I2 98.0%), and 82.0% (71.8%‐90.3%, I2 60.96%) respectively. The neck, lumbar spine, and thoracic spine were the most commonly involved areas. One of 9 studies on contributing factors investigated discomfort as an outcome. The remainder focussed on surrogate outcomes (eg, posture, hand dysfunction). Two of the 13 intervention studies investigated pain or fatigue as an outcome. The remainder targeted posture, muscle activity, or workload.ConclusionWRMDs are highly prevalent in endoscopic sinus and skull base surgeons. Further studies focusing on the direct outcomes of WRMD such as pain are needed.

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Patient and physician positioning during anterior skull base surgery impacts physician ergonomics

Cited by 3 publications

References 15 publications

Female Surgical Ergonomics in Otolaryngology: A National Survey Study

Female Surgical Ergonomics in Otolaryngology: A National Survey Study

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

Work‐Related Musculoskeletal Disorders in Endoscopic Sinus and Skull Base Surgery: A Systematic Review With Meta‐analysis

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