Workload Differentiates Breast Surgical Procedures: NSM Associated with Higher Workload Demand than SSM

Area of Science:

• Surgical Oncology
• Ergonomics
• Musculoskeletal Health

Background:

• Breast surgery techniques are advancing to improve cosmetic results, increasing complexity and operative time.
• The impact of these surgical advancements on surgeon mental and physical demands remains unclear.
• This study evaluates surgeon workload and ergonomic risk in breast procedures.

Purpose of the Study:

• To prospectively assess mental and physical demands during breast surgery.
• To compare surgeon ergonomic risk between nipple-sparing mastectomy (NSM) and skin-sparing mastectomy (SSM).
• To utilize subjective and objective measures for evaluating surgeon workload and posture.

Main Methods:

• Surgeons completed modified NASA-Task Load Index (TLX) surveys post-operatively.
• Inertial measurement units tracked surgeon postures during NSM and SSM procedures.
• Analysis included surgical posture angles, ergonomic risk scores, and patient factors.

Main Results:

• Procedural duration correlated with surgeon frustration, mental/physical demand, and fatigue.
• Nipple-sparing mastectomy (NSM) was rated 23% more physically demanding and required 28% more effort than skin-sparing mastectomy (SSM).
• Higher trunk musculoskeletal disorder risk was linked to increased physical workload; NSM showed greater left arm abduction angles.

Conclusions:

• Nipple-sparing mastectomy (NSM) imposes the highest workload, including physical demand and effort, among breast procedures.
• Objective data revealed the surgeon's left upper arm is at the highest risk for work-related musculoskeletal disorders during NSM.
• Incision type significantly influences surgeon workload and procedural difficulty.