Ergonomics in laparoscopy; An Analytical Questionnaire Survey.

Ergonomics in laparoscopy – An Analytical survey of Operative laparoscopy related physical and mental strain and consequences on the health of surgical team with literature review.

Aim and Objectives

To assess the acute and chronic Musculo skeletal pain, eye strain, mental stress, fatigue, trips and falls in dark room among laparoscopic surgeons performing major and intermediate gynaecological procedures on regular basis. 

Study design & Methodology

Electronic questionnaire survey of national and international gynaecological endoscopists, undertaking complex major and intermediate laparoscopic surgery from high-volume centres.

Introduction

The minimal invasive procedures have become popular over the last two decades. High technological complexity, prolonged surgical time, poorly adapted equipment leads to surgeon’s fatigue and discomfort during laparoscopic surgery along with mental stress. Ergonomic adaptation and appropriate laparoscopic operating theatre structure are essential to improve efficiency, safety, and comfort for the operating team which reduces fatigue, mental and physical strains on surgeons.

Results

132 responses received from united kingdom, America, India and Greece. Surgical procedures included laparoscopic hysterectomy, treatment of severe endometriosis, laparoscopic adhesiolysis and cystectomy and selective gynaecological oncology procedures.

Surgical duration was two hours in 62 % and over two hours in 38%. Surgeons did two to three typical operating lists per week in 70% of survey and 30 % did daily laparoscopy at laparoscopy centre. The Neck, shoulder and back pain were reported in 86%, Fatigue in 90%, Eye strain in 40%, head ache in 50%, Fingers and thumbs ache from graspers and diathermy in 60% , Fall and fracture in 4% (due to trips in dark room). Mental stress was noted in 70%. Contributing factors were, new assisting team in 40%, inappropriate Equipment choice or set up that needed improvement in 80% . Other contributing factors were Poor concentration from assisting team in 30%, delays and distractions in 50%.

What made surgeons feel better were Ergonomic  laparoscopy equipment, dedicated laparoscopy set up and consistent presence of trained team in 90% . The impacts on surgeons were short and long term sickness,  cancellation of personal social events in 20% , Sickness absence in 20%.

Conclusions

Right ergonomics friendly laparoscopy equipment and laparoscopy set up with trained team reduces the post-surgical physical and mental strain on operating team. Ergonomic adaptation and appropriate laparoscopic operating theatre structure are essential to improve efficiency, safety, and comfort for the operating team. Understanding the ergonomics involved in laparoscopy, reduces fatigue and physical strains on surgeon.