Page 37 - World Journal of Laparoscopic Surgery

REVIEW ARTICLE
Review of Ergonomics in Minimally Invasive Surgery

Premkumar Anandan
Received on: 20 April 2022; Accepted on: 20 May 2022; Published on: 05 September 2023

AbstrAct
Musculoskeletal occupational injury is prevalent within the surgical community. This is a multi-factorial issue but is contributed to by physical
posture, environmental hazards, and administrative deficiency. There is growing awareness of this issue, with several behavioral, educational, and
administrative techniques being employed. The literature on this topic is, however, sporadic and difficult to access by healthcare practitioners.
The aim of this review was to evaluate the literature on the current interventions used to minimize musculoskeletal occupational injury in surgeons
and interventionalists. This review will focus on engineering interventions, administrative interventions, and personal protective equipment.
Keywords: Ergonomics, Laparoscopic, Minimal invasive surgery.
World Journal of Laparoscopic Surgery (2023): 10.5005/jp-journals-10033-1543

IntroductIon
Department of Surgery, Bangalore Medical College & Research
Surgeons generally concentrate on procedural improvement and Institute, Bengaluru, Karnataka, India
strive toward perfection. One of the crucial factors which will Corresponding Author: Premkumar Anandan, Department of
enhance the abilities and ensure smooth conduct of the surgical Surgery, Bangalore Medical College & Research Institute, Bengaluru,
procedures is ergonomics. Even though ergonomics is learned Karnataka, India, Phone: +91 9886575767, e-mail: drpremk512@gmail.
during training, it is commonly ignored or not strictly adhered to. com
This might impede and rather increase the learning curve. How to cite this article: Anandan P. Review of Ergonomics in Minimally
The synchronicity of the surgeon and his workplace, and Invasive Surgery. World J Lap Surg 2023;16(1):36–42.
the operating room is one of the important elements that surely Source of support: Nil
influences the whole experience of the surgeon. The topic of Conflict of interest: None
ergonomics has not been of priority among researchers. Sporadic
research has been trying to establish some recommendations but
has not been quite successful in ensuring the strict adaptation of The work injury not just affected the professional life at the
ergonomic principles. operating but surprising impacted the social life also. A study
Surgeons with their routine of performing complex and revealed that 41% of the participants agreed that this pain due to
technically demanding surgeries are highly prone to occupational the work injury negatively affected their relationships. The other
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hazards. Surgeons during the procedures tend to be positioned in major concern was sleep which was disturbed and possibly reduced
very awkward or non-neutral positions and often for long durations cognitive abilities subsequently leading to unwarranted errors
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which will lead to musculoskeletal problems. Specialty surgeons of during the procedures. As a result of the multi-facet influence of
plastic operate wearing coupes and they have to bend sharply at occupational hazard, the long-term career would be clearly affected
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the neck region which causes cervical region strain; the other good and even end in burnout.
example is the orthopedics who wear heavy lead aprons which The necessity for intervention in form of medications was
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cause muscular fatigue. A heavy lead apron can even injure the noted in 29%, and most of the others felt that the pain increased
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vertebral disc prolapse. 5–8 only during performing the procedure. Few (31%) even had to
The evolution of open surgery into minimal access surgery undergo surgery due to the pain.
has hugely benefitted the patients but unfortunately made the Another major impact was seen in form of sick leave. A survey
surgeon’s life more demanding. The technical challenge of minimal showed as many as 26% took sick leave and 40% had to make
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access surgery pushes the risk of musculoskeletal injuries. 5,9–26 The some mechanical adjustment in the operating room. All these
surgeon’s freedom of movement and odd positions for long hours significant effects show the glaring need for attention.
increase the risk by many folds. These occupational injuries have a wide range of consequences,
The ergonomic peril has been addressed in the recent decade. ranging from physical pains to psychological bearing. A survey
Many randomized controlled trials (RCTs) have shown the risk revealed that many 47% of the surgeons feared that this injury
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among surgeons as high as 68% in form of pain. Surgeons will surely reduce their career span. This concern is not just an
performing minimal access surgery face this occupational injury, assumption, but rather a survey among the ophthalmic plastic
and to an extent of 87% of surgeons reporting it as per the study surgeons reported to have stopped operating due to either pain
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by Park et al., the injury to the back and the incidence of disc or fear of spinal injury. 32
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prolapse has been reported around 15%. The areas involved were The wellbeing of the healthcare workers and here the surgeon
commonly the back in which ~50% the upper body is involved is of utmost importance. This will undoubtedly matter in patient
including the shoulders, and arms were average around 45%. care. A total of 30% of surgeons admitted that their symptoms

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