Interventions to Improve Ergonomics in the Operating Theatre: A Systematic Review of Ergonomics Training and Intra-operative Microbreaks

Overview

Journal Ann Med Surg (Lond)

Publisher Wolters Kluwer

Specialty Medical Education

Date 2020 Jun 2

PMID 32477512

Citations 9

Authors

Kiron Koshy

Habib Syed

Andrew Luckiewicz

Daniel Alsoof

George Koshy

Lorraine Harry

Affiliations

Soon will be listed here.

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 behavioural, 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 systematic review was to evaluate the literature on the current interventions used to minimise musculoskeletal occupational injury in surgeons and interventionalists. This review will focus on administrative and human factor interventions, such as intra-operative microbreaks and ergonomics training.

Citing Articles

Importance of Exercise for Career Longevity: Maintaining Fitness, Strength, and Flexibility as a Plastic Surgeon.

Rogoff H, Byrnes Y, Kauffman C Plast Reconstr Surg Glob Open. 2025; 13(1):e6439.

PMID: 39882430 PMC: 11778094. DOI: 10.1097/GOX.0000000000006439.

Ergonomics in the operating room and surgical training: a survey on the Italian scenario.

Restaino S, DIndinosante M, Perelli F, Arcieri M, Cherchi V, Petrillo M Front Public Health. 2024; 12:1417250.

PMID: 39171296 PMC: 11337608. DOI: 10.3389/fpubh.2024.1417250.

Using wearable technology for Posture Regulation to Improve Surgical Ergonomics in the paediatric operating room: the UPRISE trial: a pilot study.

Soni S, Ritchie A, Liu S, Pacilli M, Nataraja R Surg Endosc. 2024; 38(8):4445-4456.

PMID: 38902409 PMC: 11289160. DOI: 10.1007/s00464-024-10933-5.

Ergonomic interventions to reduce upper limb musculoskeletal pain during robotic surgery: a narrative review.

Wong S, Parkes A, Crowe P J Robot Surg. 2024; 18(1):224.

PMID: 38801617 PMC: 11130008. DOI: 10.1007/s11701-024-01992-w.

Influence of Intraoperative Active and Passive Breaks in Simulated Minimally Invasive Procedures on Surgeons' Perceived Discomfort, Performance, and Workload.

Bonsch R, Seibt R, Kramer B, Rieger M, Steinhilber B, Luger T Life (Basel). 2024; 14(4).

PMID: 38672698 PMC: 11051257. DOI: 10.3390/life14040426.

References

Diks J, Jaspers J, Wisselink W, de Mol B, Grimbergen C . The mechanical master-slave manipulator: an instrument improving the performance in standardized tasks for endoscopic surgery. Surg Endosc. 2007; 21(6):1025-31. DOI: 10.1007/s00464-006-9038-2. View

Van Dyke J, Bain J, Riley D . Stretch-activated signaling is modulated by stretch magnitude and contraction. Muscle Nerve. 2013; 49(1):98-107. DOI: 10.1002/mus.23880. View

Stucky C, Cromwell K, Voss R, Chiang Y, Woodman K, Lee J . Surgeon symptoms, strain, and selections: Systematic review and meta-analysis of surgical ergonomics. Ann Med Surg (Lond). 2018; 27:1-8. PMC: 5832650. DOI: 10.1016/j.amsu.2017.12.013. View

Janki S, Mulder E, IJzermans J, Tran T . Ergonomics in the operating room. Surg Endosc. 2016; 31(6):2457-2466. PMC: 5443844. DOI: 10.1007/s00464-016-5247-5. View

Giberti C, Gallo F, Francini L, Signori A, Testa M . Musculoskeletal disorders among robotic surgeons: a questionnaire analysis. Arch Ital Urol Androl. 2014; 86(2):95-8. DOI: 10.4081/aiua.2014.2.95. View

Engelmann C, Schneider M, Kirschbaum C, Grote G, Dingemann J, Schoof S . Effects of intraoperative breaks on mental and somatic operator fatigue: a randomized clinical trial. Surg Endosc. 2010; 25(4):1245-50. DOI: 10.1007/s00464-010-1350-1. View

Vijendren A, Yung M, Sanchez J . Occupational health issues amongst UK doctors: a literature review. Occup Med (Lond). 2015; 65(7):519-28. DOI: 10.1093/occmed/kqv088. View

Davis W, Fletcher S, Guillamondegui O . Musculoskeletal occupational injury among surgeons: effects for patients, providers, and institutions. J Surg Res. 2014; 189(2):207-212.e6. DOI: 10.1016/j.jss.2014.03.013. View

Berquer R, SMITH W, Davis S . An ergonomic study of the optimum operating table height for laparoscopic surgery. Surg Endosc. 2002; 16(3):416-21. DOI: 10.1007/s00464-001-8190-y. View

10.

Sivak-Callcott J, Mancinelli C, Nimbarte A . Cervical occupational hazards in ophthalmic plastic surgery. Curr Opin Ophthalmol. 2015; 26(5):392-8. DOI: 10.1097/ICU.0000000000000182. View

11.

Manasnayakorn S, Cuschieri A, Hanna G . Ergonomic assessment of optimum operating table height for hand-assisted laparoscopic surgery. Surg Endosc. 2008; 23(4):783-9. DOI: 10.1007/s00464-008-0068-9. View

12.

McGill S, Hughson R, Parks K . Lumbar erector spinae oxygenation during prolonged contractions: implications for prolonged work. Ergonomics. 2000; 43(4):486-93. DOI: 10.1080/001401300184369. View

13.

Voss R, Chiang Y, Cromwell K, Urbauer D, Lee J, Cormier J . Do No Harm, Except to Ourselves? A Survey of Symptoms and Injuries in Oncologic Surgeons and Pilot Study of an Intraoperative Ergonomic Intervention. J Am Coll Surg. 2016; 224(1):16-25.e1. DOI: 10.1016/j.jamcollsurg.2016.09.013. View

14.

Waters T, Short M, Lloyd J, Baptiste A, Butler L, Petersen C . AORN ergonomic tool 2: positioning and repositioning the supine patient on the OR bed. AORN J. 2011; 93(4):445-9. DOI: 10.1016/j.aorn.2010.08.027. View

15.

Nagpal K, Vats A, Ahmed K, Smith A, Sevdalis N, Jonannsson H . A systematic quantitative assessment of risks associated with poor communication in surgical care. Arch Surg. 2010; 145(6):582-8. DOI: 10.1001/archsurg.2010.105. View

16.

Coleman Wood K, Lowndes B, Buus R, Hallbeck M . Evidence-based intraoperative microbreak activities for reducing musculoskeletal injuries in the operating room. Work. 2018; 60(4):649-659. DOI: 10.3233/WOR-182772. View

17.

Sergesketter A, Lubkin D, Shammas R, Krucoff K, Peskoe S, Risoli Jr T . The Impact of Ergonomics on Recruitment to Surgical Fields: A Multi-Institutional Survey Study. J Surg Res. 2019; 236:238-246. DOI: 10.1016/j.jss.2018.11.035. View

18.

Reddy P, Reddy T, Roig-Francoli J, Cone L, Sivan B, DeFoor W . The impact of the alexander technique on improving posture and surgical ergonomics during minimally invasive surgery: pilot study. J Urol. 2011; 186(4 Suppl):1658-62. DOI: 10.1016/j.juro.2011.04.013. View

19.

Van Eerd D, Munhall C, Irvin E, Rempel D, Brewer S, van der Beek A . Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence. Occup Environ Med. 2015; 73(1):62-70. PMC: 4717459. DOI: 10.1136/oemed-2015-102992. View

20.

Zheng B, Martinec D, Cassera M, Swanstrom L . A quantitative study of disruption in the operating room during laparoscopic antireflux surgery. Surg Endosc. 2008; 22(10):2171-7. DOI: 10.1007/s00464-008-0017-7. View