Ergonomics in the operating room: protecting the surgeon.

STUDY
OBJECTIVE: To review elements of an ergonomic operating room environment and describe common ergonomic errors in surgeon posture during laparoscopic and robotic surgery.
DESIGN: Descriptive video based on clinical experience and a review of the literature (Canadian Task Force classification III).
SETTING: Community teaching hospital affiliated with a major teaching hospital. SUBJECTS/AUDIENCE: Gynecologic surgeons. INTERVENTION: Demonstration of surgical ergonomic principles and common errors in surgical ergonomics by a physical therapist and surgeon.
MEASUREMENTS AND MAIN RESULTS: The physical nature of surgery necessitates awareness of ergonomic principles. The literature has identified ergonomic awareness to be grossly lacking among practicing surgeons, and video has not been documented as a teaching tool for this population. Taking this into account, we created a video that demonstrates proper positioning of monitors and equipment, and incorrect and correct ergonomic positions during surgery. Also presented are 3 common ergonomic errors in surgeon posture: forward head position, improper shoulder elevation, and pelvic girdle asymmetry. Postural reset and motion strategies are demonstrated to help the surgeon learn techniques to counterbalance the sustained and awkward positions common during surgery that lead to muscle fatigue, pain, and degenerative changes.
CONCLUSION: Correct ergonomics is a learned and practiced behavior. We believe that video is a useful way to facilitate improvement in ergonomic behaviors. We suggest that consideration of operating room setup, proper posture, and practice of postural resets are necessary components for a longer, healthier, and pain-free surgical career.