Advertisement
Review Article| Volume 53, P209-220, September 2019

Musculoskeletal Disorders in Minimally Invasive Surgery

      Laparoscopic surgery has led to profound patient benefit since its introduction, but this has come at a great cost to the surgeon.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Advances in Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Cuschieri A.
        The spectrum of laparoscopic surgery.
        World J Surg. 1992; 16: 1089-1097
        • Park A.
        • Lee G.
        • Seagull F.J.
        • et al.
        Patients benefit while surgeons suffer: an impending epidemic.
        J Am Coll Surg. 2010; 210: 306-313
      1. Int Ergon Assoc (IEA): what is ergonomics?.
        (Available at:) (Accessed October 10, 2018)
        • Cuschieri A.
        Whither minimal access surgery: tribulations and expectations.
        Am J Surg. 1995; 169: 9-19
        • Klein M.
        • Anderson L.P.H.
        • Alamili M.
        • et al.
        Psychological and physical stress in surgeons operating in a standard or modern operating room.
        Surg Laparosc Endosc Percutan Tech. 2010; 20: 237-242
        • Bohm B.
        • Rotting N.
        • Schwenk W.
        • et al.
        A prospective randomized trial on heart rate variability of the surgical team during laparoscopic and conventional sigmoid resection.
        Arch Surg. 2001; 136: 305-310
        • Vereczkei A.
        • Feussner H.
        • Negele T.
        • et al.
        Ergonomic assessment of the static stress confronted by surgeons during laparoscopic cholecystectomy.
        Surg Endosc. 2004; 18: 1118-1122
        • Berguer R.
        • Smith W.
        An ergonomic comparison of robotic and laparoscopic technique: the influence of surgeon experience and task complexity.
        J Surg Res. 2006; 134: 87-92
        • Matern U.
        • Faist M.
        • Kehl K.
        • et al.
        Monitor position in laparoscopic surgery.
        Surg Endosc. 2005; 19: 436-440
        • Berguer R.
        • Smith W.D.
        • Chung Y.H.
        Performing laparoscopic surgery is significantly more stressful for the surgeon than open surgery.
        Surg Endosc. 2001; 15: 1204-1207
        • Seagull F.
        Disparities between industrial and surgical ergonomics.
        Work. 2012; 41: 4669-4672
        • Kenngott H.
        • Fischer L.
        • Nickel F.
        • et al.
        Status of robotic assistance—a less traumatic and more accurate minimally invasive surgery?.
        Langenbecks Arch Surg. 2012; 397: 333-341
        • Esposito C.
        • Najmaldin A.
        • Schier F.
        • et al.
        Work-related upper limb musculoskeletal disorders in pediatric minimally invasive surgery: a multicentric survey comparing laparoscopic and SILS ergonomy.
        Pediatr Surg Int. 2014; 30: 395-399
        • Berguer R.
        • Rab G.T.
        • Abu-Ghaida H.
        • et al.
        A comparison of surgeons’ posture during laparoscopic and open surgical procedures.
        Surg Endosc. 1997; 11: 139-142
        • Quick N.E.
        • Gillette J.C.
        • Shapiro R.
        • et al.
        The effect of using laparoscopic instruments on muscle activation patterns during minimally invasive surgical training procedures.
        Surg Endosc. 2003; 17: 462-465
        • Lee Y.H.
        • Chiou W.K.
        Ergonomic analysis of working posture in nursing personnel: example of modified Ovako Working Analysis System application.
        Res Nurs Health. 1995; 18: 67-75
        • Kant I.J.
        • de Jong L.C.
        • van Rijssen-Moll M.
        • et al.
        A survey of static and dynamic work postures of operating room staff.
        Int Arch Occup Environ Health. 1992; 63: 423-428
        • Rademacher K.
        • Pichler K.V.
        • Erbse S.
        • et al.
        Using human factor analysis and VR simulation techniques for the optimization of the surgical worksystem.
        Stud Health Technol Inform. 1996; 29: 532-541
        • Alleblas C.C.
        • de Man A.M.
        • van den Haak L.
        • et al.
        Prevalence of musculoskeletal disorders among surgeons performing minimally invasive surgery.
        Ann Surg. 2017; 266: 905-920
        • Giberti C.
        • Gallo F.
        • Francini L.
        • et al.
        Musculoskeletal disorders among robotic surgeons: a questionnaire analysis.
        Arch Ital Urol Androl. 2014; 86: 96-98
        • Huysmans M.
        • Hoozemans M.
        Fatigue effects on tracking performance and muscle activity.
        J Electromyogr Kinesiol. 2008; 18: 410-419
        • Huysmans M.
        • Hoozemans M.
        Position sense acuity of the upper extremity and tracking performance in subjects with non-specific neck and upper extremity pain and healthy controls.
        J Rehabil Med. 2010; 42: 876-883
        • Lee G.
        • Lee T.
        • Dexter D.
        • et al.
        Methodological infrastructure in surgical ergonomics: a review of tasks, models, and measurement systems.
        Surg Innov. 2007; 14: 153-167
        • Lee G.I.
        • Lee M.R.
        • Clanton T.
        • et al.
        Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries.
        Surg Endosc. 2014; 28: 456-465
        • Lee E.C.
        • Rafiq A.
        • Merrell R.
        • et al.
        Ergonomics and human factors in endoscopic surgery: a comparison of manual vs. telerobotic simulation systems.
        Surg Endosc. 2005; 19: 1064-1070
        • Stefanidis D.
        • Wang F.
        • Korndorffer J.R.
        • et al.
        Robotic assistance improves intracorporeal suturing performance and safety in the operating room while decreasing operator workload.
        Surg Endosc. 2010; 24: 377-382
        • Stefanidis D.
        • Hope W.W.
        • Scott D.J.
        Robotic suturing on the FLS model possesses construct validity, is less physically demanding, and is favored by more surgeons compared with laparoscopy.
        Surg Endosc. 2011; 25: 2141-2146
        • Klein M.I.
        • Warm J.S.
        • Riley M.A.
        • et al.
        Mental workload and stress perceived by novice operators in the laparoscopic and robotic minimally invasive surgical interfaces.
        J Endourol. 2012; 26: 1089-1094
        • Marecik S.J.
        • Prasad L.M.
        • Park J.J.
        • et al.
        Evaluation of midlevel and upper-level residents performing their first robotic-sutured intestinal anastomosis.
        Am J Surg. 2008; 195: 333-337
        • Zihni A.
        • Ohu I.
        • Cavallo J.
        • et al.
        Ergonomic analysis of robot-assisted and traditional laparoscopic procedures.
        Surg Endosc. 2014; 28: 3379-3384
        • Park A.
        “Physician heal thyself” isn't working.
        Ann Surg. 2017; 266: 921-922
        • Lee G.
        • Sutton E.
        • Clanton T.
        • et al.
        Higher physical workload risks with NOTES versus laparoscopy: a quantitative ergonomic assessment.
        Surg Endosc. 2011; 25: 1585-1593
        • Shergill A.K.
        • McQuaid K.R.
        • Rempel D.
        Ergonomics and GI endoscopy.
        Gastrointest Endosc. 2009; 70: 145-153
        • Liberman A.S.
        • Shrier I.
        • Gordon P.H.
        Injuries sustained by colorectal surgeons performing colonoscopy.
        Surg Endosc. 2005; 19: 1606-1609
        • West C.P.
        Physician well-being: expanding the triple aim.
        J Gen Intern Med. 2016; 31: 458-459
        • Hamidi M.S.
        • Boqqild M.K.
        • Cheung A.M.
        Running on empty: a review of nutrition and physicians’ well-being.
        Postgrad Med J. 2016; 92: 478-481
        • Rothenberger D.A.
        Physician burnout and well-being: a systematic review and framework for action.
        Dis Colon Rectum. 2017; 60: 567-576
        • Arora M.
        • Asha S.
        • Chinnappa J.
        • et al.
        Review article: burnout in emergency medicine physicians.
        Emerg Med Australas. 2013; 25: 491-495
        • Arora M.
        • Diwan A.D.
        • Harris I.A.
        Burnout in orthopaedic surgeons: a review.
        ANZ J Surg. 2013; 83: 512-515
        • Schneider S.
        • Kingsolver K.
        • Rosdahl J.
        Physician coaching to enhance well-being: a qualitative analysis of a pilot intervention.
        Explore (NY). 2014; 10960: 372-379
        • Blum A.B.
        • Shea S.
        • Czeisler C.A.
        • et al.
        Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision and safety.
        Nat Sci Sleep. 2011; 3: 47-85
      2. Farmer E, Brownson A. Review of workload measurement, analysis and interpretation methods (CARE-Integra-RES-130-02-WP2). Technical report prepared for the European Organisation for the Safety of Air Navigation. Brussels, Belgium: Eurocontrol.

        • McLean L.
        • Tingley M.
        • Scott R.N.
        • et al.
        Computer terminal work and the benefit of microbreaks.
        Appl Ergon. 2001; 32: 225-237
        • Caceres-Munoz V.S.
        • Magallances-Meneses A.
        • Torres-Coronel D.
        • et al.
        Effect of rest pauses combined with information leaflets on the decrease in musculoskeletal pain in administrative workers.
        Rev Peru Med Exp Salud Publica. 2017; 34: 611-618
        • Mukhopadhyay B.K.
        Strategic rest break in laparoscopic surgery: a need.
        World J Laparosc Surg. 2012; 5: 85-88
        • Englemann C.
        • Schneider M.
        • Kirschbaum C.
        • et al.
        Effects of intraoperative breaks on mental and somatic operator fatigue: a randomized clinical trial.
        Surg Endosc. 2011; 25: 1245-1250
        • Park A.E.
        • Zahiri H.R.
        • Hallbeck M.S.
        • et al.
        Intraoperative “Micro Breaks” with targeted stretching enhance surgeon physical function and mental focus: a multicenter cohort study.
        Ann Surg. 2017; 265: 340-346
        • Schrempf M.
        • Anthuber M.
        Intraoperative microbreaks reduce pain and improve concentration.
        Chirurg. 2017; 88: 256
        • Reddy P.
        • Reddy T.
        • Roig-Francoli J.
        • et al.
        The impact of the Alexander technique on improving posture and surgical ergonomics during minimally invasive surgery: pilot study.
        J Urol. 2011; 186: 1658-1662
        • Herron D.M.
        • Gagner M.
        • Kenyon T.L.
        • et al.
        The minimally invasive surgical suite enters the 21st century.
        Surg Endosc. 2001; 15: 415-422
        • Sancibrian R.
        • Gutierrez-Diez M.C.
        • Torre-Ferrero C.
        • et al.
        Design and evaluation of a new ergonomic handle for instruments in minimally invasive surgery.
        J Surg Res. 2014; 188: 88-99