Differences in postural loading between primary and assistant surgeons during vaginal surgery

Abstract

While increasing attention has been given to the prevalence of work-related musculoskeletal disorders (WMDs) among surgeons in various medical specialties, there is no quantitative information about the potential work-related risk factors that contribute to WMDs among vaginal surgeons in the operating room (OR). This study aimed to quantify the frequency and duration of awkward postures, as well as musculoskeletal discomfort experienced by primary and assistant vaginal surgeons during surgery in order to provide a first step of informing ergonomics interventions that reduce postural loading during surgery. Thirteen primary and 14 assistant surgeons were evaluated during 13 surgical cases. Surgeon pre- and post-operative musculoskeletal discomfort ratings were collected with surveys. During surgery, real-time observations systematically characterized the frequency and duration of awkward neck, trunk and shoulder postures using tablet-based ergonomics software. Surgeons experienced postoperative increases in musculoskeletal discomfort of the neck, wrists, hands, back and feet. Assistant surgeons experienced greater right and left shoulder discomfort than primary surgeons (p < .05 and p < .034). The frequencies and durations of observed awkward postures were high for both primary and assistant surgeons. Assistant surgeons spent twice as long in trunk flexion than the primary surgeons. These results suggest that the postural loading experienced by assistant vaginal surgeons is for some postures higher than that of primary surgeons, and that ergonomics interventions aimed at reducing the frequency of neck, shoulder and trunk postures during surgery could potentially benefit vaginal surgeons. Relevance to industrySurgeons provide a valuable healthcare service to the public, but surgeons are at high risk of musculoskeletal problems due to their work demands. This study provides new information about the physical requirements of vaginal surgeries to inform ergonomics interventions that prevent work-related musculoskeletal disorders among primary and assistant surgeons.