Ergonomic problems encountered during video-assisted thoracic surgery

Area of Science:

• Surgical Innovation
• Occupational Health
• Operating Room Design

Background:

• Ergonomic considerations are increasingly integrated into laparoscopic surgery operating room design.
• No prior studies have specifically addressed ergonomic concerns within Video-Assisted Thoracic Surgery (VATS).

Purpose of the Study:

• To identify and describe the ergonomic issues encountered during VATS procedures.
• To propose evidence-based recommendations for operating room design tailored to thoracoscopic surgery.

Main Methods:

• Conducted observational analysis of fifteen thoracoscopic operations to document physical ergonomic problems.
• Supplemented observational data with a literature review to identify perceptual and cognitive ergonomic challenges.
• Categorized ergonomic issues into physical, perceptual, and cognitive domains.

Main Results:

• Identified two primary surgeon positions during VATS, both associated with significant ergonomic strain.
• Common issues include leg fatigue, static postures, extensive upper limb/wrist movements, and neck stiffness.
• A VATS-specific awkward posture, involving upper body rotation and leaning over the patient, exacerbates physical problems.

Conclusions:

• VATS poses unique and serious ergonomic challenges distinct from laparoscopy.
• Recommendations include reorganizing operating room setup, optimizing monitor placement, and developing specialized operating tables and instruments.
• Implementing these changes can mitigate ergonomic problems and improve surgeon comfort and efficiency in VATS.