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Impact of Intraoperative Ergonomic Microbreaks on Surgeons' Well-Being and Performance: A Systematic Review
Gabriel Heierli1, Fabian Grass1, Luís C Pereira2
1Department of Visceral Surgery, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
Background:
Surgeons face a considerable risk of work-related musculoskeletal disorders (WMSDs). Repetitive movements and poor ergonomic conditions can cause pain, particularly in the back, neck, arms, and shoulders. WMSDs not only impact surgeons' quality of life but may also affect surgical performance, absenteeism, and healthcare costs. To reduce WMSDs, intraoperative microbreaks (MBs) with active stretching exercises have been proposed. The aim of this review was to study ergonomic intraoperative MB interventions and their effect on surgeons' symptoms, well-being and performance and to define the features of efficacious interventions.
Method:
A systematic review of clinical trials evaluating physical or psychological impact of intraoperative microbreaks on surgeons was conducted in MEDLINE, Embase and Google Scholar until October 2024. Outcomes of interest included pain, discomfort, fatigue, dexterity, mental focus, stress as well as objective measures.
Results:
Ten clinical trials (284 study subjects) were retained for final analysis (8 crossover trials and 2 randomized controlled trials). Methodology and assessed outcomes varied considerably between studies. Similarly, interventions were heterogenous in terms of duration, interval, or set of exercises. 6 out of the 10 trials showed at least one improved outcome after the implementation of MBs. The most frequently assessed outcomes were pain and discomfort (improved in 5/8 studies), mental focus (improved in 3/3 studies), and accuracy (improved in 1/3 studies). Five studies evaluated operative duration, all showing no prolonged operating time associated with MBs.
Conclusion:
Microbreaks might have a positive impact on surgeons' well-being and performance. There is a clear need though for standardization of interventions and outcome measures. The long-term effects of microbreaks and the most efficacious intervention need yet to be defined.
Insights
Intraoperative microbreaks (microbreaks) with stretching may improve surgeons' well-being and performance. Further research is needed to standardize interventions and define long-term effects for optimal surgical practice.
Area of Science:
- Surgical Ergonomics
- Occupational Health
- Musculoskeletal Disorders
Background:
- Surgeons are at high risk for work-related musculoskeletal disorders (WMSDs) due to repetitive tasks and poor ergonomics.
- WMSDs negatively impact surgeons' quality of life, surgical performance, and increase healthcare costs.
- Intraoperative microbreaks (MBs) with active stretching are proposed interventions to mitigate WMSDs.
Purpose of the Study:
- To review ergonomic intraoperative MB interventions for surgeons.
- To assess the effects of MBs on surgeons' symptoms, well-being, and performance.
- To identify characteristics of effective MB interventions.
Main Methods:
- Systematic review of clinical trials in MEDLINE, Embase, and Google Scholar up to October 2024.
- Included studies evaluated physical or psychological impact of intraoperative MBs on surgeons.
- Outcomes included pain, fatigue, dexterity, mental focus, stress, and objective surgical measures.
Main Results:
- Ten trials (284 participants) were analyzed; interventions and outcomes varied.
- Six of ten trials reported at least one improved outcome with MBs.
- Pain/discomfort improved in 5/8 studies, mental focus in 3/3, and accuracy in 1/3. No studies showed prolonged operative time.
Conclusions:
- Intraoperative microbreaks show potential benefits for surgeon well-being and performance.
- Standardization of MB interventions and outcome measures is crucial.
- Long-term effects and optimal intervention protocols require further definition.