Patients recover while surgeons suffer: a narrative review on surgical ergonomics in laparoscopic surgery
Related Experiment Videos
Nabil Mohammad Azmi1, Diana Melissa Dualim2, Soma Balaganapathi2
1Department of Surgery, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. nabil@ukm.edu.my.
Background And Objective:
Laparoscopic surgery offers significant patient benefits but introduces substantial ergonomic challenges, leading to a high prevalence of work-related musculoskeletal disorders, fatigue, and burnout. This narrative review aims to synthesize current evidence on ergonomic risks in laparoscopic surgery, their impact on surgeons' health and performance and potential mitigation strategies.
Methods:
We conducted a narrative review of relevant literature on PubMed, EMBASE, Web of Science and SCOPUS databases using the keywords "surgical ergonomics, laparoscopic surgery, minimally-invasive surgery, robotic surgery, surgeon wellbeing, musculoskeletal disorder, surgeon career longevity" to elucidate this issue.
Key Content And Findings:
Ergonomic hazards frequently stem from suboptimal operating room setups, improper table and monitor positioning, "one-size-fits-all" instrument designs and non-neutral postures such as the "mirror image" effect. These factors contribute to physical complaints affecting up to 88% of laparoscopic surgeons, which may compromise surgical precision and patient safety. Assessment tools like the Rapid Upper Limb Assessment (RULA) are instrumental in quantifying these physical and cognitive demands. Potential interventions to combat this include targeted ergonomic training such as the Alexander Technique, intraoperative micro-breaks and wearable biofeedback technology. Furthermore, optimizing operating room configurations and adopting advanced technologies like robotic systems and augmented reality (AR) may significantly reduce physical exertion, though they present their own unique ergonomic challenges.
Conclusion:
Addressing surgical ergonomic challenges is vital for maintaining the physical and mental health of surgeons, ensuring the sustainability of healthcare provision and preventing attrition from surgical careers. Behavioral interventions are the cornerstone of a multifaceted approach to improving surgical ergonomics, encompassing physical adjustments, awareness training and policy development. Fostering a sustainable surgical workforce necessitates widespread awareness, formal ergonomic education and the integration of adaptive technologies and optimized operating environments.
