Megan E McDonald1, Pedro T Ramirez2, Mark F Munsell3, Marilyn Greer4, William M Burke5, Wendel T Naumann6, Michael Frumovitz7. 1. Department of Obstetrics and Gynecology, The University of Iowa, Iowa City, IA, USA. 2. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 3. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Department of Institutional Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 5. Department of Obstetrics and Gynecology, New York-Presbyterian Hospital, New York, NY, USA. 6. Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, NC, USA. 7. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: mfrumovitz@mdanderson.org.
Abstract
OBJECTIVE: Despite increasing awareness of physical strain to surgeons associated with minimally invasive surgery (MIS), its use continues to expand. We sought to gather information from gynecologic oncologists regarding physical discomfort due to MIS. METHODS: Anonymous surveys were e-mailed to 1279 Society of Gynecologic Oncology (SGO) members. Physical symptoms (numbness, pain, stiffness, and fatigue) and surgical and demographic factors were assessed. Univariate and multivariate analyses were performed to determine risk factors for physical symptoms. RESULTS: We analyzed responses of 350 SGO members who completed the survey and currently performed >50% of procedures robotically (n=122), laparoscopically (n=67), or abdominally (n=61). Sixty-one percent of members reported physical symptoms related to MIS. The rate of symptoms was higher in the robotic group (72%) than the laparoscopic (57%) or abdominal groups (49%) (p=0.0052). Stiffness (p=0.0373) and fatigue (p=0.0125) were more common in the robotic group. Female sex (p<0.0001), higher caseload (p=0.0007), and academic practice (p=0.0186) were associated with increased symptoms. On multivariate analysis, robotic surgery (odds ratio [OR] 2.38, 95% CI 1.20-4.69) and female sex (OR 4.20, 95% CI 2.13-8.29) were significant predictors of symptoms. There was no correlation between seeking treatment and surgical modality (laparotomy 11%, robotic 20%, laparoscopy 25%, p=0.12). CONCLUSIONS: Gynecologic oncologists report physical symptoms due to MIS at an alarming rate. Robotic surgery and female sex appear to be risk factors for physical discomfort. As we strive to improve patient outcomes and decrease patient morbidity with MIS, we must also work to improve the ergonomics of MIS for surgeons.
OBJECTIVE: Despite increasing awareness of physical strain to surgeons associated with minimally invasive surgery (MIS), its use continues to expand. We sought to gather information from gynecologic oncologists regarding physical discomfort due to MIS. METHODS: Anonymous surveys were e-mailed to 1279 Society of Gynecologic Oncology (SGO) members. Physical symptoms (numbness, pain, stiffness, and fatigue) and surgical and demographic factors were assessed. Univariate and multivariate analyses were performed to determine risk factors for physical symptoms. RESULTS: We analyzed responses of 350 SGO members who completed the survey and currently performed >50% of procedures robotically (n=122), laparoscopically (n=67), or abdominally (n=61). Sixty-one percent of members reported physical symptoms related to MIS. The rate of symptoms was higher in the robotic group (72%) than the laparoscopic (57%) or abdominal groups (49%) (p=0.0052). Stiffness (p=0.0373) and fatigue (p=0.0125) were more common in the robotic group. Female sex (p<0.0001), higher caseload (p=0.0007), and academic practice (p=0.0186) were associated with increased symptoms. On multivariate analysis, robotic surgery (odds ratio [OR] 2.38, 95% CI 1.20-4.69) and female sex (OR 4.20, 95% CI 2.13-8.29) were significant predictors of symptoms. There was no correlation between seeking treatment and surgical modality (laparotomy 11%, robotic 20%, laparoscopy 25%, p=0.12). CONCLUSIONS: Gynecologic oncologists report physical symptoms due to MIS at an alarming rate. Robotic surgery and female sex appear to be risk factors for physical discomfort. As we strive to improve patient outcomes and decrease patient morbidity with MIS, we must also work to improve the ergonomics of MIS for surgeons.
Authors: John F Boggess; Paola A Gehrig; Leigh Cantrell; Aaron Shafer; Mildred Ridgway; Elizabeth N Skinner; Wesley C Fowler Journal: Am J Obstet Gynecol Date: 2008-10 Impact factor: 8.661
Authors: Michael Frumovitz; Pamela T Soliman; Marilyn Greer; Kathleen M Schmeler; John Moroney; Diane C Bodurka; Pedro T Ramirez Journal: Gynecol Oncol Date: 2008-09-20 Impact factor: 5.482
Authors: Mohamed Mabrouk; Michael Frumovitz; Marilyn Greer; Sheena Sharma; Kathleen M Schmeler; Pamela T Soliman; Pedro T Ramirez Journal: Gynecol Oncol Date: 2009-01-12 Impact factor: 5.482
Authors: Joan L Walker; Marion R Piedmonte; Nick M Spirtos; Scott M Eisenkop; John B Schlaerth; Robert S Mannel; Gregory Spiegel; Richard Barakat; Michael L Pearl; Sudarshan K Sharma Journal: J Clin Oncol Date: 2009-10-05 Impact factor: 44.544
Authors: Kari L Ring; Pedro T Ramirez; Lesley B Conrad; William Burke; R Wendel Naumann; Mark F Munsell; Michael Frumovitz Journal: Int J Gynecol Cancer Date: 2015-07 Impact factor: 3.437
Authors: Kade S McQuivey; David G Deckey; Zachary K Christopher; Christian S Rosenow; Lanyu Mi; Mark J Spangehl; Joshua S Bingham Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2021-03-11