Postural stress experienced by vaginal surgeons

Abstract

Increasing attention has been drawn to the prevalence of work-related musculoskeletal disorders (MSDs) among surgeons in various medical specialties; however, the risk of work-related MSDs among gynecologic surgeons has not received much attention. This study aimed to investigate the postural load among gynecologic surgeons for various surgical tasks during vaginal surgery. The frequency and percentage of duration of awkward upper body postures experienced by vaginal surgeons during eleven different vaginal surgical tasks observed during thirteen surgeries were collected using a new observational ergonomic job analysis tool, Ergonomic Posture Assessment in Real Time (ErgoPART). Results indicate that the postural loading is high for many surgical tasks but that the frequency and duration of awkward neck, shoulder, and trunk postures is variable across tasks. Surgeons' postural load was significantly higher for the transvaginal hysterectomy compared to others. This task, in particular, is a candidate for ergonomics interventions designed to reduce postural stress.

Human factors in robotic assisted surgery: Lessons from studies ‘in the Wild’

“…However, impact of these novel techniques on the Generally, workload has been considered as "costs incurred by a human operator to achieve a particular level of performance" and evolves from interactions between task demands, circumstances and personal skills, behavior, and perceptions (Noyes and Bruneau, 2007). For physical workload, there are observational methods to analyze body posture (Zhu et al, 2014(Zhu et al, , 2017 and more recently more objective measures such as Inertial Movement Units (IMUs) (Morrow et al, 2016). Workload can also be measured objectively with EMG, heart rate or using subjective measures, such as the body part discomfort (Kuorinka et al, 1987), NASA-TLX (Hart and Staveland, 1988), and SURG-TLX (Wilson et al, 2011).…”

Effect of chair types on work-related musculoskeletal discomfort during vaginal surgery

“…7,11,14,15 The postural risk categories, calculated with the modified rapid upper limb assessment, stayed in moderate or severe risk (category 3 or 4) for the upper body Comparison of the percentage of time during the vaginal procedure spent in risk category 3 ajog.org for a majority of time, which is a matter of concern. Zhu et al 10 assessed and quantified the postural load during vaginal procedures and all the surgeons stood during the entire procedure. Similar to our findings, the authors noted that the neck was most affected during vaginal surgery.…”

“…6 The literature of evaluated ergonomic issues in obstetrics and gynecology is further limited. 7,[10][11][12][13][14][15][16] In gynecological surgery, the vaginal route is a traditional approach and involves working in a constrained space and in unfavorable postures for long durations. A survey of gynecological surgeons showed that 86.7% of surgeons performing vaginal surgery experienced work-related musculoskeletal discomfort.…”

“…14 In addition, performance of vaginal operations was the leading cause of backache among gynecologists. 15 Zhu et al 10 objectively measured and quantified postural load of surgeons during vaginal procedures and reported it to be great, especially during vaginal hysterectomy.…”

The impact of patient body mass index on surgeon posture during simulated laparoscopy

“…This framework was selected because it is upper body focused and has been shown to be most effective in medium-risk conditions [35]. An emphasis was placed on the use of a framework suited to medium-risk circumstances because LS has been shown to induce prolonged low-risk non-neutral postures as well as episodic high-risk postures [10,36,37], therefore a medium risk classification seemed to be the optimal choice given these postural habits.…”