Ruchira Singh1, Ladin A Yurteri-Kaplan2, Melissa M Morrow3,4, Amy L Weaver3, Michaela E McGree3, Xinhui Zhu5, Victor L Paquet6, John B Gebhart7, Susan Hallbeck3,4. 1. Department of Obstetrics and Gynecology, University of Florida, 653-1 W. 8th Street, Jacksonville, FL, 32209, USA. ruchira.26@gmail.com. 2. Department of Obstetrics and Gynecology, Columbia University New York Presbyterian, New York, NY, USA. 3. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. 4. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA. 5. School of Mechanical, Industrial, and Manufacturing Engineering, Oregon State University, Corvallis, OR, USA. 6. Department of Industrial and Systems Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA. 7. Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: We compared musculoskeletal discomfort and postural load among surgeons in sitting and standing positions during vaginal surgery. MATERIALS AND METHODS: Assessment of discomfort and posture of the primary surgeons in both positions was performed at two institutions. The primary outcome was an increase in body discomfort score after surgery as determined from subjective responses using validated tools. The secondary outcome was the percentage of time spent in awkward body postures measured objectively and stratified into awkward postures for neck, trunk, and bilateral shoulder angles. Variables were compared between sitting and standing positions using Fisher's exact test for primary outcomes and Wilcoxon rank-sum test for secondary outcomes. RESULTS: Data were collected for 24 surgeries from four surgeons in sitting position and nine surgeries from nine surgeons in standing position. The standing surgeons reported a significant increase in discomfort postoperatively for bilateral wrists, thighs, and lower legs compared with the sitting surgeons. The median percentage of time spent in awkward postures was significantly lower for the trunk in the standing versus sitting position (median 0.3% vs 58.8%, p < 0.001) but was significantly higher for both shoulders in the standing versus the sitting position (right shoulder: median 17.8% vs 0.3%, p = 0.003; left shoulder: median 7.4% vs 0.2%, p = 0.003). CONCLUSION: Surgeons reported more discomfort in when performing vaginal surgery while standing. The postural load was worse for trunk but favorable for bilateral shoulders when seated. Such differences may impact a surgeon's decision to perform vaginal surgery seated rather than standing.
INTRODUCTION AND HYPOTHESIS: We compared musculoskeletal discomfort and postural load among surgeons in sitting and standing positions during vaginal surgery. MATERIALS AND METHODS: Assessment of discomfort and posture of the primary surgeons in both positions was performed at two institutions. The primary outcome was an increase in body discomfort score after surgery as determined from subjective responses using validated tools. The secondary outcome was the percentage of time spent in awkward body postures measured objectively and stratified into awkward postures for neck, trunk, and bilateral shoulder angles. Variables were compared between sitting and standing positions using Fisher's exact test for primary outcomes and Wilcoxon rank-sum test for secondary outcomes. RESULTS: Data were collected for 24 surgeries from four surgeons in sitting position and nine surgeries from nine surgeons in standing position. The standing surgeons reported a significant increase in discomfort postoperatively for bilateral wrists, thighs, and lower legs compared with the sitting surgeons. The median percentage of time spent in awkward postures was significantly lower for the trunk in the standing versus sitting position (median 0.3% vs 58.8%, p < 0.001) but was significantly higher for both shoulders in the standing versus the sitting position (right shoulder: median 17.8% vs 0.3%, p = 0.003; left shoulder: median 7.4% vs 0.2%, p = 0.003). CONCLUSION: Surgeons reported more discomfort in when performing vaginal surgery while standing. The postural load was worse for trunk but favorable for bilateral shoulders when seated. Such differences may impact a surgeon's decision to perform vaginal surgery seated rather than standing.
Keywords:
Ergonomics; Musculoskeletal discomfort; Postural load; Vaginal surgery
Authors: Antonia C Wells; Magnus Kjellman; Simon J F Harper; Mikael Forsman; M Susan Hallbeck Journal: Surg Endosc Date: 2018-11-19 Impact factor: 4.584