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Microbreaks in Laparoscopic Appendectomy have No Effect on Surgeons' Performance and Well-being
Laurits Schou Kromberg1, Niels Vinkel Kildebro2, Laura Quitzau Mortensen2
1Department of Anesthesiology, Holbaek Hospital, Holbaek, Denmark.
Background:
Musculoskeletal fatigue and pain as a consequence of performing surgery is found in 70%-87% of surgeons. The aim of this study was to examine the effect of microbreaks on surgeons' performance and well-being during laparoscopic appendectomy.
Materials And Methods:
The study was a blinded randomized crossover trial. Twelve surgeons were tested at three time points: Before surgery (baseline), after surgery without intervention, and after surgery where microbreaks were used every 10 min for 10 s. The musculoskeletal endurance test was used as the primary outcome. Performance was assessed by procedure length and a manual precision test. The surgeons' well-being was measured by level of exhaustion rated on the Borg CR10 scale and visual analog scale ratings for musculoskeletal discomfort in the neck, shoulders, back, wrists, and legs.
Results:
No significant differences were found in musculoskeletal endurance, procedure time, or the manual precision test. The level of exhaustion was significantly increased after both normal procedures (P = 0.01) and procedures with microbreaks (P = 0.03). However, no significant difference was found between the two (P = 0.25). There was a significant increase from baseline regarding self-reported musculoskeletal discomfort in the back, shoulders, and legs after surgery but no significant differences between procedures with and without microbreaks.
Conclusions:
This study did not find a positive effect of microbreaks on laparoscopic appendectomy. Exhaustion and discomfort were present after surgery, demonstrating that short surgical procedures (less than 60 min) can result in fatigue in surgeons.
Insights
Microbreaks did not improve surgeon performance or reduce fatigue during laparoscopic appendectomy. Surgeons still experienced exhaustion and discomfort after short procedures, indicating fatigue is a significant issue in surgical settings.
Area of Science:
- Surgical Science
- Occupational Health
- Human Factors Engineering
Background:
- Surgeons frequently experience musculoskeletal fatigue and pain, affecting 70%-87% of practitioners.
- Laparoscopic appendectomy is a common surgical procedure where surgeon fatigue can be a concern.
Purpose of the Study:
- To investigate the impact of microbreaks on surgeon performance and well-being during laparoscopic appendectomy.
- To assess if short, frequent rests can mitigate fatigue and discomfort in surgeons.
Main Methods:
- A blinded randomized crossover trial involving twelve surgeons.
- Evaluated musculoskeletal endurance, procedure length, and manual precision.
- Assessed surgeon well-being using exhaustion and pain rating scales.
Main Results:
- No significant differences were observed in musculoskeletal endurance, procedure time, or manual precision between groups.
- Surgeon exhaustion increased significantly after both standard and microbreak procedures, with no difference between them.
- Musculoskeletal discomfort in the back, shoulders, and legs increased post-surgery, irrespective of microbreak use.
Conclusions:
- Microbreaks did not demonstrate a positive effect on surgeon performance or well-being in laparoscopic appendectomy.
- Short surgical procedures (<60 min) can lead to significant surgeon fatigue and discomfort.
- Further research may be needed to explore effective fatigue mitigation strategies for surgeons.
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