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Work-related upper limb musculoskeletal disorders in paediatric laparoscopic surgery. A multicenter survey
Ciro Esposito1, Alaa El Ghoneimi, Atsuyuki Yamataka
1Pediatric Surgery Units, Federico II University Naples, Italy. ciroespo@unina.it
Insights
Pediatric laparoscopic surgeons experience significant work-related musculoskeletal symptoms (WMS), particularly shoulder pain, which increases with surgical experience. Laparoscopy is associated with more WMS than open procedures, highlighting ergonomic concerns.
Area of Science:
- Surgical Ergonomics
- Occupational Health
- Musculoskeletal Disorders
Background:
- Surgeons face a high risk of developing work-related musculoskeletal symptoms (WMS).
- Pediatric laparoscopic surgeons are a specific group evaluated for WMS.
- Physical factors contributing to WMS in this population are examined.
Purpose of the Study:
- To investigate the physical factors associated with WMS in pediatric laparoscopic surgeons.
- To compare WMS prevalence between laparoscopic and open procedures.
- To assess the impact of surgical experience on WMS.
Main Methods:
- A 21-question survey was distributed to 25 pediatric laparoscopic surgeons.
- Surgeons were divided into experienced (LG1) and less experienced (LG2) groups.
- A comparative survey on WMS after open procedures (OG) was also administered.
Main Results:
- 78.2% of surgeons with over 10 years of laparoscopy experience reported shoulder WMS.
- WMS were more prevalent in laparoscopic surgeons (78.2%) compared to open procedure surgeons (56.5%).
- Experienced laparoscopic surgeons (LG1) showed higher WMS rates (84.6%) than less experienced ones (LG2).
Conclusions:
- A strong link exists between WMS and the volume of laparoscopic procedures performed.
- More experienced laparoscopic surgeons report higher incidences of WMS.
- Shoulder symptoms are the most commonly reported WMS among these surgeons.
Background:
Surgeons are at risk for developing work-related musculoskeletal symptoms (WMS). The present study aims to examine the physical factors and their association with WMS among pediatric laparoscopic surgeons.
Methods:
A questionnaire consisting of 21 questions was created and mailed to 25 pediatric laparoscopic surgeons (LG). 23/25 surgeons (92%) completed the survey. The questionnaire was analyzed and then split into 2 groups. Group 1 (LG1) included surgeons with greater laparoscopic experience, and group 2 (LG2) included surgeons with less important laparoscopic experience. In addition, we constructed and sent to the same surgeons a similar questionnaire focused on WMS after an open procedure (OG) with the aim to compare results of LG with OG.
Results:
The prevalence rate of WMS with shoulder symptoms was 78.2% in surgeons that performed laparoscopy for more than 10 years, with 60.8% also reporting other pain. In 66.6% this pain is evident only after a long-lasting procedure. Forty-four percent of these surgeons require painkillers at least twice a week. Fifty percent of these surgeons also suffer at home. Fifty-five and one half percent of surgeons indicate that this pain is related to their laparoscopic activity. Forty-three and a half percent think that laparoscopy is beneficial only for the patient but has a bad ergonomic effect for surgeons. Sixty-five and two-tenths percent think that robotic surgery can be helpful to improve ergonomics. Comparing the groups, WMS occur more frequently in LG (78.2%) than in OG (56.5%), but this difference was not statistically significant (χ(2)=0.05). In addition, WMS occur more frequently in LG1 (84.6%) than in LG2 (70%), but this difference was not statistically significant (χ(2)=0.05).
Conclusions:
These results confirmed a strong association between WMS and the number of laparoscopic procedures performed. Skilled laparoscopic surgeons have more pain than less skilled laparoscopic surgeons. WMS in the same group of surgeons are more frequent after laparoscopy than after open procedures. The majority of surgeons refer to shoulder symptoms.