Surgeons' perceptions and injuries during and after urologic laparoscopic surgery

Area of Science:

• Urology
• Surgical Technology
• Occupational Health

Background:

• Laparoscopic surgery imposes greater biomechanical and mental stress on surgeons compared to open procedures.
• Understanding the prevalence and nature of injuries in laparoscopic urologic surgery is crucial for surgeon well-being.

Purpose of the Study:

• To assess the occurrence of deleterious perceptions or injuries among urologists performing laparoscopic surgery.
• To identify specific laparoscopic techniques associated with higher injury risks.

Main Methods:

• A questionnaire was distributed to members of an endourological society.
• Surgeons reported their experience with standard laparoscopic surgery (SLS), hand-assisted laparoscopic surgery (HALS), and robotic-assisted laparoscopic surgery (RALS).
• Respondents detailed any neuromuscular or arthritic injuries and graded pain, numbness, and fatigue experienced during procedures.

Main Results:

• Out of 73 urologists, 30% reported neuromuscular or arthritic symptoms, with finger paresthesia being the most common (18%).
• Hand-assisted laparoscopic surgery (HALS) resulted in hand/wrist numbness in 45% and pain in 37% of surgeons.
• A higher total number of laparoscopic procedures correlated significantly with increased injury risk (P = 0.016); RALS had the lowest injury association, HALS the highest.

Conclusions:

• The laparoscopic operating environment presents significant ergonomic challenges.
• Increased surgeon awareness of common injuries and pre-operative equipment adjustments are essential for injury mitigation.
• Instrument design improvements based on ergonomic principles are strongly recommended for future laparoscopic surgery.