Assessment methods for surgeons' ergonomics in the operating room: a scoping review

Area of Science:

• Surgical Ergonomics
• Human Factors in Surgery
• Occupational Health in Medicine

Background:

• Ergonomics is critical for safe, high-quality surgical care.
• Existing research on surgical ergonomics lacks standardization in settings, terminology, and methods.
• This variability hinders the comparability and generalizability of findings.

Purpose of the Study:

• To systematically map the terminology and methods used for evaluating surgeons' ergonomics.
• To provide a structured overview of current ergonomic assessment practices in real-world surgical environments.
• To identify gaps and inconsistencies in the existing body of research.

Main Methods:

• A systematic literature search was conducted across multiple databases (MEDLINE, Embase, CENTRAL, IEEE Xplore, ICTRP, ClinicalTrials.gov) up to July 1, 2025.
• Two independent reviewers screened studies, extracted data on study characteristics and outcomes, and categorized assessment tools (self-reported, observational, instrumental, computer-based).
• The review protocol was registered with PROSPERO (CRD420251088370).

Main Results:

• Ninety-nine studies met inclusion criteria, predominantly focusing on minimally invasive surgery (laparoscopic and robotic).
• Physical, cognitive, and organizational ergonomics were assessed, with significant heterogeneity in terminology and methods observed.
• Physical ergonomics often used observational/instrumental methods, cognitive ergonomics relied on self-reports, and computer-based tools (including AI) are emerging.

Conclusions:

• The review established a framework for surgical ergonomics assessment but revealed substantial heterogeneity.
• There is a clear need for standardized, multimodal, and objective assessment approaches.
• Standardization will improve the comparability and reliability of future ergonomic research in surgery.