Human Factors Evaluation of Surgeons' Working Positions for Gynecologic Minimal Access Surgery

Abstract

Study ObjectiveTo investigate work-related musculoskeletal disorders (WRMSD) in gynaecological minimal access surgery (MAS), including bariatric (plus size) patients DesignMixed methods (Canadian Task Force classification III). SettingTeaching hospital in the United Kingdom. MeasurementsSurvey, observations (anthropometry, postural analysis), and interviews. ResultsWork-related musculoskeletal disorders (WRMSDs) were present in 63% of the survey respondents (n = 67). The pilot study (n = 11) identified contributory factors, including workplace layout, equipment design, and preference of port use (relative to patient size). Statistically significant differences for WRMSD-related posture risks were found within groups (average-size mannequin and plus-size mannequin) but not between patient size groups, suggesting that port preference may be driven by surgeon preference (and experience) rather than by patient size. ConclusionSome of the challenges identified in this project need new engineering solutions to allow flexibility to support surgeon choice of operating approach (open, laparoscopic or robotic) with a workplace that supports adaptation to the task, the surgeon, and the patient.