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. 2024 May 31;14(1):12502.
doi: 10.1038/s41598-024-63516-8.

Evaluating the surgical trainee ergonomic experience during minimally invasive abdominal surgery (ESTEEMA study)

Cassandra Chan #  1 , Ying Ching Tan #  2 , Ee Wen Lim  2 , Jin-Yao Teo  3 , Jinlin Lin  4 , Winson JianHong Tan  5 , Gerald Ci An Tay  6 , Emile Kwong-Wei Tan  2 , Isaac Seow-En  7
Affiliations

Evaluating the surgical trainee ergonomic experience during minimally invasive abdominal surgery (ESTEEMA study)

Cassandra Chan et al. Sci Rep. .

Abstract

Minimally invasive abdominal surgery (MAS) can exert a physical cost. Surgical trainees spend years assisting minimally-invasive surgeries, increasing the risk of workplace injury. This prospective questionnaire-based cohort study was conducted amongst general surgery residents in Singapore. Residents assisting major MAS surgery were invited to complete anonymous online survey forms after surgery. The Phase 1 survey assessed physical discomfort scores and risk factors. Intraoperative measures to improve ergonomics were administered and evaluated in Phase 2. During Phase 1 (October 2021 to April 2022), physical discomfort was reported in at least one body part in 82.6% (n = 38) of respondents. Over a third of respondents reported severe discomfort in at least one body part (n = 17, 37.0%). Extremes of height, training seniority, longer surgical duration and operative complexity were significant risk factors for greater physical discomfort. In Phase 2 (October 2022 to February 2023), the overall rate of physical symptoms and severe discomfort improved to 81.3% (n = 52) and 34.4% (n = 22) respectively. The ergonomic measure most found useful was having separate television monitors for the primary surgeon and assistants, followed by intraoperative feedback on television monitor angle or position. Close to 20% of survey respondents felt that surgeon education was likely to improve physical discomfort.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Body part distribution and frequencies of severe physical discomfort (defined as discomfort scores of 4 or 5) amongst 46 surgical trainees assisting minimally invasive abdominal surgery (ESTEEMA Phase 1).
Figure 2
Figure 2
Frequencies of responses for factors contributing to surgical assistants’ physical discomfort during minimally invasive abdominal surgery (ESTEEMA Phase 1).
Figure 3
Figure 3
Frequencies of responses for measures likely to improve surgical assistants’ physical discomfort during minimally invasive abdominal surgery (ESTEEMA Phase 1).
Figure 4
Figure 4
Evaluation of measures used to improve surgical assistants’ physical discomfort during minimally invasive abdominal surgery (ESTEEMA Phase 2).
See this image and copyright information in PMC

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References

    1. Harrell AG, Heniford BT. Minimally invasive abdominal surgery: Lux et veritas past, present, and future. Am. J. Surg. 2005;190:239–243. doi: 10.1016/j.amjsurg.2005.05.019. - DOI - PubMed
    1. Zhang G, Wu B. Meta-analysis of the clinical efficacy of laparoscopic appendectomy in the treatment of acute appendicitis. World J. Emerg. Surg. 2022;17:26. doi: 10.1186/s13017-022-00431-1. - DOI - PMC - PubMed
    1. Coccolini F, Catena F, Pisano M, et al. Open versus laparoscopic cholecystectomy in acute cholecystitis. Systematic review and meta-analysis [published correction appears in Int J Surg. 2015 Dec; 24(Pt A):107] Int. J. Surg. 2015;18:196–204. doi: 10.1016/j.ijsu.2015.04.083. - DOI - PubMed
    1. Bonjer HJ, Hop WC, Nelson H, et al. Laparoscopically assisted vs open colectomy for colon cancer: A meta-analysis. Arch. Surg. 2007;142:298–303. doi: 10.1001/archsurg.142.3.298. - DOI - PubMed
    1. Tekkis PP, Senagore AJ, Delaney CP, Fazio VW. Evaluation of the learning curve in laparoscopic colorectal surgery: Comparison of right-sided and left-sided resections. Ann. Surg. 2005;242:83–91. doi: 10.1097/01.sla.0000167857.14690.68. - DOI - PMC - PubMed