Muscular and mental fatigue in surgeons

Abstract

We read the article by Slack et al with great interest. This study provided experimental evidence for a linear relation between the extent of surgeons’ muscular fatigue and operation length. This is an important message as muscle fatigue can potentially impact fine motor control in surgeons, thus affecting the outcome of the operation. Besides muscular fatigue, we believe that mental fatigue (which is characterised by subjective feelings of ‘tiredness’ and ‘lack of energy’ induced by prolonged periods of demanding cognitive activity)1 could also infuence physical performance2 and thus operation success. For this reason, we recently asked 38 orthopaedic surgeons working in our institution (Schulthess Clinic, Zurich, Switzerland) to complete a survey on muscular and mental fatigue consecutive to an operation day. Muscular fatigue was classified as ‘low to moderate’ by 84% of the surgeons, mainly in back (53%) and lower extremity (29%) muscles. More importantly, mental fatigue was graded as ‘moderate to high’ by 85% of the surgeons and a similar percentage was observed after an ambulatory day. Again, this demon-strates the importance of minimising mental as well as mus-cular fatigue in an effort to improve surgeons’ success (and patient care), both on operation days and between.