Improving the Breast Surgeon's Ergonomic Workload for Nipple-Sparing Mastectomies Using Exercise and Operating Room...

Area of Science:

• Surgical Ergonomics
• Musculoskeletal Health
• Medical Device Technology

Background:

• Nipple-sparing mastectomy (NSM) requires specific surgeon positioning.
• Assessing surgeon physical and mental workload is crucial for optimizing surgical procedures.

Purpose of the Study:

• To evaluate the impact of an exercise program and standardized operating room positioning protocol (EOPP) on surgeon muscle workload and perceived mental/physical exertion during NSM.

Main Methods:

• Prospective analysis of electromyography (EMG) data from surgeons performing NSM before and after EOPP implementation.
• Surveys assessing surgeon perception of mental and physical workload were administered.
• EMG data were analyzed using repeated-measures ANOVA, controlling for relevant procedural variables.

Main Results:

• The EOPP significantly decreased ergonomic workload in the left and right upper trapezius muscles (P = 0.005, P = 0.020).
• No significant changes in workload were observed for cervical erector spinae, anterior deltoid, or lumbar erector spinae muscles.
• Surgeons reported increased physical (P = 0.01) and mental (P = 0.002) demands and worse visualization (P = 0.04) after EOPP implementation.

Conclusions:

• The EOPP effectively reduced workload in specific upper body muscles but did not improve overall surgeon-reported mental or physical workload.
• Variability in muscle exertion exists among surgeons, indicating a need for personalized ergonomic strategies.
• Further research is necessary to develop improved ergonomic interventions for NSM surgeons.