How Surgical Ergonomics Impact Surgeon Wellbeing, Outcomes, and Careers

• 78% of respondents reported current or prior pain and/or injury attributed to performing surgery—20% higher than reported in a 2012 survey.
• The most affected areas were the neck/cervical spine (63%), shoulders/arms (44%), lower back/lumbar spine (36%), and hands/wrists (31%).
• Half of the respondents were diagnosed with musculoskeletal condition( s) attributed to performing surgery.
• Two-thirds required treatment (62% pharmacologic only, 9% pharmacologic and surgical intervention) for their work-related pain.
• Using intermittent pauses during procedures to adjust body position was the most reported method of addressing pain in the operating room (50%), followed by ignoring the problem/working through the pain (48%).
• Only 21% reported ever receiving ergonomic training during their career, but 92% desired surgical ergonomic training.
• 91% would be willing to incorporate intraoperative stretching.
• 65% would be willing to incorporate ergonomic checks into current pre-incision timeouts.

Results from a 2019 survey from 569 endoscopic surgeons (84% males and 94% right-handed) indicated that more than 62% of surgeons reported their worst pain score as a 3 or higher on a 10-point scale in past week, encompassing 71% of open cases, 72% of laparoscopic cases, 48% of robot-assisted cases, and 52% of their endoscopies done. Of the 120 surgeons who reported ever seeking medical help for pain or discomfort, 38% were currently in pain, 16% had considered leaving surgery due to their musculoskeletal pain, and 26% had been on short-term disability at some time during their careers. These surgeons reported significantly lower satisfaction from their work, higher burnout, and significantly higher callousness toward people than those not fearing the loss of career longevity (Surg Endosc. 2019;33:933–940).

Ergonomic hazards and work-related musculoskeletal disorders (WRMSD) are among the most impactful, yet unrecognized, occupational hazards for all surgeons. —Julie L. Wei, MD, MMM

Another report, published in the same year in The Laryngoscope (2019;129:370–376), focused on ergonomic hazards in otolaryngology. This intraoperative observational and survey study used the Rapid Entire Body Assessment scoring system to identify hazards during different subspecialty procedures and a survey to evaluate ergonomic practice, environment infrastructure, and prior ergonomic training/education. Of 70 surgeons at a single institution (a 69% response rate), 72.9% reported suffering from some level of back pain, with cervical spine pain being most common. Residents experienced the same level of pain as more senior surgeons, with 43.8% of surgeons reporting the highest level of pain when standing compared to 12.5% when sitting, 10% reporting that pain had impacted their work as surgeons, and 24% reporting having no prior ergonomic training.