Occupational Strain in Vascular Surgery: A Narrative Review of Musculoskeletal and Physiological Stress and Its...

Vascular surgery imposes substantial physical and psychological demands, with up to 78% of surgeons reporting work-related musculoskeletal pain and 41% experiencing symptoms of burnout. Prolonged lead apron use, static operative postures, high-stress emergency cases, and irregular schedules compound these risks, yet few wellness frameworks are tailored specifically to this specialty.

We performed a focused review of the literature on surgeon musculoskeletal discomfort, stress biomarkers (cortisol), and burnout and synthesized data from national surveys-such as the Society for Vascular Surgery Wellness Task Force; n = 872-alongside controlled studies of exercise and mindfulness interventions. We synthesized this evidence as a focused narrative review centered on the occupational strain most specific to vascular surgery: work-related musculoskeletal injury and the physiological stress of emergency cases.

Brief, thrice-daily stretching routines have been shown to reduce self-reported musculoskeletal pain by up to 35%, and intraoperative microbreaks reduce muscle fatigue without prolonging operative time. Emergency cases are associated with significantly greater cortisol elevations than elective cases, persisting for up to 24 hours postoperatively, and with a 62% greater autonomic stress response. Evidence from adjacent high-stakes fields suggests that brief breathing and cognitive-pause techniques may improve stress physiology and reduce technical errors, although direct vascular surgery data are lacking.

This narrative review synthesizes the available evidence on occupational strain specific to vascular surgery, focusing on work-related musculoskeletal injury and the physiological stress of emergency cases. The evidence supports targeted ergonomic and stress-mitigation strategies and identifies clear gaps for future specialty-specific study, with the ultimate aims of preserving surgeon well-being and patient care.