Institutional members access full text with Ovid®

Share this article on:

Ergonomics in Surgery: A Review

Catanzarite, Tatiana, MD*†; Tan-Kim, Jasmine, MD, MAS; Whitcomb, Emily, L., MD, MAS; Menefee, Shawn, MD

Female Pelvic Medicine & Reconstructive Surgery: January/February 2018 - Volume 24 - Issue 1 - p 1–12
doi: 10.1097/SPV.0000000000000456
Review Article

Objective Work-related musculoskeletal disorders (WMSDs) are prevalent among surgeons and may result in practice modification. We aimed to perform a comprehensive review of the English-language literature regarding ergonomic risk, prevalence of WMSDs, and unique ergonomic considerations by route of surgery.

Methods Multiple searches were performed of PubMed and University library resources to access English-language publications related to surgeon ergonomics. Combinations of keywords were used for each mode of surgery, including the following: “ergonomics,” “guidelines,” “injury,” “operating room,” “safety,” “surgeon,” and “work-related musculoskeletal disorders.” Each citation was read in detail, and references were reviewed.

Results Surgeon WMSDs are prevalent, with rates ranging from 66% to 94% for open surgery, 73% to 100% for conventional laparoscopy, 54% to 87% for vaginal surgery, and 23% to 80% for robotic-assisted surgery. Risk factors for injury in open surgery include use of loupes, headlamps, and microscopes. Unique risks in laparoscopic surgery include table and monitor position, long-shafted instruments, and poor instrument handle design. In vaginal surgery, improper table height and twisted trunk position create injury risk. Although robotic surgery offers some advantages, it remains associated with trunk, wrist, and finger strain. Surgeon WMSDs often result in disability but are under-reported to institutions. Additionally, existing research tools face limitations in the operating room environment.

Conclusions Work-related musculoskeletal disorders are prevalent among surgeons but have received little attention owing to under-reporting of injury and logistical constraints of studying surgical ergonomics. Future research must aim to develop objective surgical ergonomics instruments and guidelines and to correlate ergonomics assessments with pain and tissue-level damage in surgeons with WMSDs. Ergonomics training should be developed to protect surgeons from preventable, potentially career-altering injuries.

Although work-related musculoskeletal disorders are common among surgeons and may adversely impact career longevity, ergonomic interventions have not been emphasized for surgeons, largely owing to under-reporting of injury and technical limitations of studying ergonomics in the operating room.

From the *Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Reproductive Medicine, University of California; †Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Kaiser Permanente, San Diego; and ‡Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Kaiser Permanente, Orange County, CA.

Reprints: Tatiana Catanzarite, MD, 9500 Gilman Dr, MC 0971, La Jolla, CA 92093-0971. E-mail: tcatanza@gmail.com.

The authors have declared they have no conflicts of interest.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.