Chloe S H Ong1, Daniele Castellani2, Dmitry Gorelov3, Irene Girón-Nanne4, Kondala Govindaraju Jyothi Swaroop5, Mariela Corrales6, Meshari Alshaashaa7, Vinson W S Chan8, B M Zeeshan Hameed9, Sung Y Cho10, Pradeep Durai1, Nariman Gadzhiev3, Saeed Bin Hamri7, Deepak Ragoori5, Esteban Emiliani4, Silvia Proietti11, Guido Giusti11, Bhaskar K Somani12, Olivier Traxer13, Jeremy Y C Teoh14, Vineet Gauhar1. 1. Division of Urology, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore. 2. Urology Division, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, Ancona, Italy. 3. Endourology Department, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russian Federation. 4. Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain. 5. Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, India. 6. Department of Urology, Sorbonne University, AP-HP, Tenon Hospital, Paris, France. 7. Division of Urology, Department of Surgery, Ministry of the National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia. 8. School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom. 9. Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India. 10. Department of Urology, Seoul National University Hospital, Seoul, Korea. 11. European Training Center of Endourology, San Raffaele Hospital, Milan, Italy. 12. University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom. 13. Sorbonne University, GRC#20 Lithiase Urinaire, Hôpital Tenon, Paris, France. 14. Department of Surgery, S.H. Ho Urology Center, The Chinese University of Hong Kong, Hong Kong, China.
Abstract
Background: With recent technological advancement, new and improved endoscopic instruments and laser devices have catapulted flexible ureteroscopy to the forefront, hence making retrograde intrarenal surgery (RIRS) a popular choice for the management of renal stones. However, RIRS has also resulted in an increasing number of work-related musculoskeletal disorders, which can have a detrimental impact on surgeons' physical health and operative lifespan. The aim of our review is to examine the impact and feasibility of ergonomic adjustments and outline future directions and recommendations to improve the awareness of and reduce the prevalence of musculoskeletal injuries among urologists. Methods: This study was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A thorough literature review was conducted of several databases using the following keywords and Medical Subject Headings (MeSH) terms to generate a search strategy: nephrolithiasis, kidney calculus, renal calculus, staghorn calculus, ergonomics, position, fatigue, comfort, tire, physical strain, visual strain, muscle, ureteroscopy, RIRS, laser, and lithotripsy. Studies were chosen for inclusion by reviewers independently, and the data were consolidated for analysis. Results: A total of 1446 articles were identified on initial literature search; 23 were included in the final analysis. The impact of various ergonomic modifications on operative outcomes, surgeons, surgical equipment, and patients, was analyzed. In addition, we summarized all the improvements that resulted in better ergonomics in RIRS. Conclusion: Ergonomics in RIRS is poorly understood and there are currently no formal guidelines for this aspect. While modern endourology armamentarium seems to help with procedural ergonomics, more needs to be done to enhance surgeon comfort, protect surgeon longevity, and prioritize the health and safety of endourologists.
Background: With recent technological advancement, new and improved endoscopic instruments and laser devices have catapulted flexible ureteroscopy to the forefront, hence making retrograde intrarenal surgery (RIRS) a popular choice for the management of renal stones. However, RIRS has also resulted in an increasing number of work-related musculoskeletal disorders, which can have a detrimental impact on surgeons' physical health and operative lifespan. The aim of our review is to examine the impact and feasibility of ergonomic adjustments and outline future directions and recommendations to improve the awareness of and reduce the prevalence of musculoskeletal injuries among urologists. Methods: This study was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A thorough literature review was conducted of several databases using the following keywords and Medical Subject Headings (MeSH) terms to generate a search strategy: nephrolithiasis, kidney calculus, renal calculus, staghorn calculus, ergonomics, position, fatigue, comfort, tire, physical strain, visual strain, muscle, ureteroscopy, RIRS, laser, and lithotripsy. Studies were chosen for inclusion by reviewers independently, and the data were consolidated for analysis. Results: A total of 1446 articles were identified on initial literature search; 23 were included in the final analysis. The impact of various ergonomic modifications on operative outcomes, surgeons, surgical equipment, and patients, was analyzed. In addition, we summarized all the improvements that resulted in better ergonomics in RIRS. Conclusion: Ergonomics in RIRS is poorly understood and there are currently no formal guidelines for this aspect. While modern endourology armamentarium seems to help with procedural ergonomics, more needs to be done to enhance surgeon comfort, protect surgeon longevity, and prioritize the health and safety of endourologists.
Entities:
Keywords:
ergonomics; nephrolithiasis; retrograde intrarenal surgery