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ergonomics best practices for surgeons-1

Problem

  • Up to 86% of surgeons report work related pain[1]
  • Surgeons are often exposed to non-neutral neck and shoulder postures for prolonged periods of time[2]
  • Adequate knowledge of ergonomics has been reported in as few as 11% of practicing surgeons[3]

Risk Factors

Head Forward Position & Neck Flexion

  • For every inch the head moves forward in space, its relative weight increases by 10 lbs., increasing the demand on neck muscles[3]
  • Limiting neck flexion to 20 degrees can result in lower levels of discomfort[4]

Sustained and Awkward Shoulder Elevation

  • Shoulder abduction and internal rotation are commonly observed during laparoscopic surgeries
  • Increased muscle activation leads to development of fatigue

Lower Limb Support Asymmetry

  • Surgeons frequently shift their weight from side-to-side during prolonged surgeries
  • Postural imbalance can result in increased shear forces in the lumbar spine

 

 

Engineering Controls

equipment recommendations

contactus@sandalwood.com

  • Adjust Monitor position and height
    • Target: 15-40° below eye level
    • Approximately ‘arm’s length’ away
  • Operating Table height
    • Target: relaxed elbows and shoulders
  • Placement of Foot pedals
    • Aligned with the direction of torso
  • Home offices are working environments too!
    • Follow recommended ergonomic principles pertaining to chair, desk, monitor, and peripheral requirements

 

Administrative Controls

  • Take Frequent ‘Microbreaks’ for Postural Resets
    • Target: 30s every 20min [2,5]
    • Drop shoulders and relax the hands
    • Self-assess for body weight asymmetry
  • Perform Stretches before, during, and after experiencing prolonged static postures
    • Alternating Arm Raises (bilateral/unilateral)
    • Standing Squats
  • Avoid locking the knees whenever possible
  • Actively promote and participate in ergonomics programs within your workplace!

 

 

 

 

References

[1] Park, A. et al. Patients benefit while surgeons suffer: an impending epidemic, J. Am. Coll. Surg.

[2] Dorion, D. Darveau, S. 2013. Do Micropauses Prevent Surgeon’s Fatigue and Loss of Accuracy Associated with Prolonged Surgery? An Experimental Prospective Study, Ann Surg.

[3] Rosenblatt, P. L. et al. 2013. Ergonomics in the operating room: protecting the surgeon. J Minim Invasive Gynecol.

[4] Franasiak, J. M. et al. 2014. Feasibility and effectiveness of an ergonomics training program to address high rates of strain among robotic surgeons. JSLS.

[5] Shiromani, J. et al. 2017. Ergonomics in the operating room. Surg Endosc.

[5] Seagull, F. J. 2012 Disparities between industrial and surgical ergonomics. Work.

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