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Review
. 2018 Jan 9:27:1-8.
doi: 10.1016/j.amsu.2017.12.013. eCollection 2018 Mar.

Surgeon symptoms, strain, and selections: Systematic review and meta-analysis of surgical ergonomics

Chee-Chee H Stucky  1 , Kate D Cromwell  1 , Rachel K Voss  1 , Yi-Ju Chiang  1 , Karin Woodman  2 , Jeffrey E Lee  1 , Janice N Cormier  1
Affiliations
Review

Surgeon symptoms, strain, and selections: Systematic review and meta-analysis of surgical ergonomics

Chee-Chee H Stucky et al. Ann Med Surg (Lond). .

Abstract

Background: Many surgeons experience work-related pain and musculoskeletal symptoms; however, comprehensive reporting of surgeon ailments is lacking in the literature. We sought to evaluate surgeons' work-related symptoms, possible causes of these symptoms, and to report outcomes associated with those symptoms.

Materials and methods: Five major medical indices were queried for articles published between 1980 and 2014. Included articles evaluated musculoskeletal symptoms and ergonomic outcomes in surgeons. A meta-analysis using a fixed-effect model was used to report pooled results.

Results: Forty articles with 5152 surveyed surgeons were included. Sixty-eight percent of surgeons surveyed reported generalized pain. Site-specific pain included pain in the back (50%), neck (48%), and arm or shoulder (43%). Fatigue was reported by 71% of surgeons, numbness by 37%, and stiffness by 45%. Compared with surgeons performing open surgery, surgeons performing minimally invasive surgery (MIS) were significantly more likely to experience pain in the neck (OR 2.77 [95% CI 1.30-5.93]), arm or shoulder (OR 4.59 [2.19-9.61]), hands (OR 2.99 [1.33-6.71], and legs (OR 12.34 [5.43-28.06]) and experience higher odds of fatigue (8.09 [5.60-11.70]) and numbness (6.82 [1.75-26.65]). Operating exacerbated pain in 61% of surgeons, but only 29% sought treatment for their symptoms. We found no direct association between muscles strained and symptoms.

Conclusions: Most surgeons report work-related symptoms but are unlikely to seek medical attention. MIS surgeons are significantly more likely to experience musculoskeletal symptoms than surgeons performing open surgery. Symptoms experienced do not necessarily correlate with strain.

Keywords: %MVIC, percentage of the maximal voluntary isometric contraction; EMG, electromyography; GEE, generalized estimating equations; MIS, minimally invasive surgery; MVIC, maximal voluntary isometric contraction; Minimally invasive surgery; Surgical ergonomics.

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Figures

Fig. 1
Fig. 1
Flow diagram for surgical ergonomics systematic review and meta-analysis.
Fig. 2
Fig. 2
Frequency of work-related site-specific symptoms in surveyed surgeons.
Fig. 3
Fig. 3
Forest plot representing results of the meta-analysis of odds ratios for work-related symptoms experienced by surgeons who performed minimally invasive surgery vs. those who performed open surgery.
Fig. 4
Fig. 4
Surgeons' opinions about and reactions to work-related symptoms stratified by surgical approach.
See this image and copyright information in PMC

References

    1. Forst L., Friedman L., Shapiro D. Carpal tunnel syndrome in spine surgeons: a pilot study. Arch. Environ. Occup. Health. 2006;61(6):259–262. - PubMed
    1. Reyes D.A.G., Tang B., Cuschieri A. Minimal access surgery (MAS)-related surgeon morbidity syndromes. Surg Endosc Other Intervent Techniq. 2006;20(1):1–13. - PubMed
    1. Tzeng Y.S., Chen S.G., Chen T.M. Herniation of the cervical disk in plastic surgeons. Ann. Plast. Surg. 2012;69(6):672–674. - PubMed
    1. Rohrich R.J. Why I hate the headlight... and other ways to protect your cervical spine. Plast. Reconstr. Surg. 2001;107(4):1037–1038. - PubMed
    1. Cass G.K., Vyas S., Akande V. Prolonged laparoscopic surgery is associated with an increased risk of vertebral disc prolapse. J. Obstet. Gynaecol. 2014;34(1):74–78. - PubMed