Prevalence of work-related musculoskeletal symptoms in surgeons performing minimally invasive surgery: a review of literature

Dabholkar, Twinkle Y.; Yardi, Sujata; Dabholkar, Yogesh G.

doi:10.18203/2349-2902.isj20161437

Cited by 5 publications

(6 citation statements)

References 9 publications

(9 reference statements)

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“…Performing surgeries laparoscopically instead of open is beneficial for the patient’s well-being [ 6 – 8 ]; however, surgeons are put at higher risk for developing musculoskeletal complaints and disorders due to the constrained and static working postures associated with laparoscopy [ 2 – 5 ]. This study evaluated the organizational measure of passive and active intraoperative work breaks compared to no breaks during simulated laparoscopy with respect to muscular fatigue, muscular activity, upper body posture, heart rate, and heart rate variability.…”

Section: Discussionmentioning

confidence: 99%

“…Also, among all surgeons, the prevalence of WRMSD is reported to be 19% [ 1 ]. In different studies, about 55% [ 2 ], 74% [ 3 ], 87% [ 4 ], or up to 88% [ 5 ] of the laparoscopic surgeons reported experiencing musculoskeletal symptoms or discomfort due to their work. Because of patient benefits laparoscopy is generally preferred over open surgery (e.g., lower infection rates, shorter recovery times) [ 6 – 8 ], particularly as a result of this also during the COVID-19-Pandemic [ 9 ].…”

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confidence: 99%

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Intraoperative active and passive breaks during minimally invasive surgery influence upper extremity physical strain and physical stress response—A controlled, randomized cross-over, laboratory trial

Luger¹,

Bonsch

Seibt³

et al. 2023

Surg Endosc

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Objective Investigate the effect of passive, active or no intra-operative work breaks on static, median and peak muscular activity, muscular fatigue, upper body postures, heart rate, and heart rate variability. Background Although laparoscopic surgery is preferred over open surgery for the benefit of the patient, it puts the surgeons at higher risk for developing musculoskeletal disorders especially due to the less dynamic and awkward working posture. The organizational intervention intraoperative work break is a workplace strategy that has previously demonstrated positive effects in small-scale intervention studies. Methods Twenty-one surgeons were exposed to three 90-min conditions: no breaks, 2.5-min passive (standing rest) or active (targeted stretching and mobilization exercises) breaks after 30-min work blocks. Muscular activity and fatigue of back, shoulder and forearm muscles were assessed by surface electromyography; upper body posture, i.e., spinal curvature, by inclination sensors; and heart rate and variability (HRV) by electrocardiography. Generalized estimating equations were used for statistical analyses. This study (NCT03715816) was conducted from March 2019 to October 2020. Results The HRV-metric SDNN tended to be higher, but not statistically significantly, in the intervention conditions compared to the control condition. No statistically significant effects of both interventions were detected for muscular activity, joint angles or heart rate. Conclusion Intraoperative work breaks, whether passive or active, may counteract shoulder muscular fatigue and increase heart rate variability. This tendency may play a role in a reduced risk for developing work-related musculoskeletal disorders and acute physical stress responses.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Intraoperative active and passive breaks during minimally invasive surgery influence upper extremity physical strain and physical stress response—A controlled, randomized cross-over, laboratory trial

Luger¹,

Bonsch

Seibt³

et al. 2023

Surg Endosc

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“…In recent studies, 19% of surgeons reported experiencing musculoskeletal symptoms or discomfort due to their work [8], with laparoscopic surgeons at the highest risk, ranging from 55% to 88% [9][10][11][12]. One approach on the part of occupational physiology is workrelated organizational interventions for reducing work-related musculoskeletal disorders.…”

Section: Introductionmentioning

confidence: 99%

Influence of Intraoperative Active and Passive Breaks in Simulated Minimally Invasive Procedures on Surgeons’ Perceived Discomfort, Performance, and Workload

Bonsch,

Seibt,

Krämer

et al. 2024

Life

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Laparoscopic surgeons are at high risk of experiencing musculoskeletal discomfort, which is considered the result of long-lasting static and awkward body postures. We primarily aimed to evaluate whether passive and active work breaks can reduce ratings of perceived discomfort among laparoscopic surgeons compared with no work breaks. We secondarily aimed to examine potential differences in performance and workload across work break conditions and requested the surgeons evaluate working with passive or active work breaks. Following a balanced, randomized cross-over design, laparoscopic surgeons performed three 90 min laparoscopic simulations without and with 2.5 min passive or active work breaks after 30 min work blocks on separate days. The simulation included the following tasks: a hot wire, peg transfer, pick-and-place, pick-and-tighten, pick-and-thread, and pull-and-stick tasks. Ratings of perceived discomfort (CR10 Borg Scale), performance per subtask, and perceived workload (NASA-TLX) were recorded, and the break interventions were evaluated (self-developed questionnaire). Statistical analyses were performed on the rating of perceived discomfort and a selection of the performance outcomes. Twenty-one participants (9F) were included, with a mean age of 36.6 years (SD 9.7) and an average experience in laparoscopies of 8.5 years (SD 5.6). Ratings of perceived musculoskeletal discomfort slightly increased over time from a mean level of 0.1 to 0.9 but did not statistically significantly differ between conditions (p = 0.439). Performance outcomes of the hot wire and peg transfer tasks did not statistically significantly differ between conditions. The overall evaluation by the participants was slightly in favor regarding the duration and content of active breaks and showed a 65% likelihood of implementing them on their own initiative in ≥90 min-lasting laparoscopic surgeries, compared with passive breaks. Both passive and active breaks did not statistically significantly influence ratings of perceived discomfort or perceived workload in a 90 min simulation of laparoscopic surgery, with an overall low mean level of perceived discomfort of 0.9 (SD 1.4). As work breaks do not lead to performance losses, rest breaks should be tested in real-life situations across a complete working shift, where perceived discomfort may differ from this laboratory situation. However, in this respect, it is crucial to investigate the acceptance and practicality of intraoperative work breaks in feasibility studies in advance of assessing their effectiveness in follow-up longitudinal trials.

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Section: Introductionmentioning

confidence: 99%

“…8 9 According to a recent review of the literature, prevalence rates of WRMSD among endoscopists, urologists, gynaecologists, otolaryngologists and ophthalmologists performing MIS range between 43% and 88%. 10 The most affected body sites are the neck, back and shoulders. 11 12 Two types of interventions addressing the working conditions could potentially be applied to counteract the prevalence of WRMSD in the surgical environment: interventions related to workplace factors and interventions related to work-organisational factors.…”

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confidence: 99%

Active and passive work breaks during simulated laparoscopy among laparoscopic surgeons: study protocol for a controlled, randomised cross-over laboratory trial

et al. 2020

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IntroductionLaparoscopy has partially replaced open surgery due to the lower infection rate for the patient and hence better and shorter recovery. However, the surgeon’s physical load is higher due to longer duration static and awkward body postures, increasing the risk for developing work-related musculoskeletal disorders. Interventions of an organisational nature are work breaks, being either passive or active. The primary objectives of this study are to determine whether passive and active work breaks lead to less discomfort than no work breaks and whether active work breaks lead to less discomfort than passive work breaks.Methods and analysisA controlled, randomised cross-over trial will be performed in the laboratory, of which its protocol is described here according to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement. Recruitment of 21 laparoscopic surgeons started in April 2019 and the study is ongoing. The participating surgeons will perform three 1.5 hour experimental conditions, one without work breaks, one with 2.5 min passive work breaks including rest, and one with 2.5 min active work breaks including mobility and stretching exercises. The work breaks will be taken after 30 and 60 min of work. During the experiments, outcomes will be recorded. The primary outcome is rating of perceived discomfort measured on an 11-point numeric rating scale. The secondary outcomes are performance, muscle activity of selected muscles, upper body angles, heart rate, workload and subjective evaluation of both interventions. The collected data will be tested using a one-way or two-factorial repeated-measures analysis of variance.Ethics and disseminationEthical approval of the study protocol was received by the local medical ethical committee of the University of Tübingen in February 2019 (no 618/2018BO2). The results of this study will be presented at national and international conferences, submitted for publications in peer-reviewed journals and serve as the starting point for a feasibility study.Trial registration numberNCT03715816.

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Prevalence of work-related musculoskeletal symptoms in surgeons performing minimally invasive surgery: a review of literature

Cited by 5 publications

References 9 publications

Intraoperative active and passive breaks during minimally invasive surgery influence upper extremity physical strain and physical stress response—A controlled, randomized cross-over, laboratory trial

Intraoperative active and passive breaks during minimally invasive surgery influence upper extremity physical strain and physical stress response—A controlled, randomized cross-over, laboratory trial

Influence of Intraoperative Active and Passive Breaks in Simulated Minimally Invasive Procedures on Surgeons’ Perceived Discomfort, Performance, and Workload

Active and passive work breaks during simulated laparoscopy among laparoscopic surgeons: study protocol for a controlled, randomised cross-over laboratory trial

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