Recommendations for Improving Ergonomics in Cleft Palate and Lip Surgery: A Scoping Review

Introduction: Craniofacial and cleft surgeries demand high precision, often leading to significant ergonomic challenges for surgeons. This review highlights critical recommendations for mitigating musculoskeletal disorders and enhancing surgeon well-being through equipment optimization, posture adjustments, and innovative technologies. Methods: To conduct this scoping review, a search of the literature yielded 18 studies which discuss ergonomics in the realm of cleft lip and palate surgery. Results: Eighteen studies were reviewed. Investigated ergonomic strategies in cleft lip and palate surgery encompassed headlights, loupes, microscopes, robots, videoscopes, endoscopes, exoscopes, positioning techniques, breaks, exercise, workshops, intubation methods, operating room design, and training programs. Most studies were classified as low risk of bias. Robotic systems and advanced visualization tools such as videoscopes and exoscopes demonstrated significant ergonomic benefits by improving surgeon posture, reducing musculoskeletal strain, and enhancing surgical precision. Microscopes and loupes offered improved magnification and comfort but were still associated with some reported musculoskeletal symptoms. Strategies including micro-breaks, exercise, ergonomic positioning, and optimized operating room setup showed potential to reduce physical discomfort during surgery. However, formal ergonomics education remains scarce in surgical training despite its recognized importance. Conclusion: Appropriate tools and positioning decrease the incidence of musculoskeletal disorders among cleft lip and palate surgeons. Further studies should focus on the outcomes of implementing such programs.