Intraoperative musculoskeletal discomfort and risk for surgeons during open and laparoscopic surgery
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and Other Interventional Techniques
2020 EAES ORAL
Intraoperative musculoskeletal discomfort and risk for surgeons during open and laparoscopic surgery Liyun Yang1,2,3 · Tianke Wang1,2 · Tiffany K. Weidner4,5 · James A. Madura II4 · Melissa M. Morrow1,2 · M. Susan Hallbeck1,2,6 Received: 28 May 2020 / Accepted: 3 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Surgeon workload is significant both mentally and physically and may differ by procedure type. When comparing laparoscopic surgery and open surgery, studies have reported contrasting results on the physical and mental workload assessed. Methods Wearable posture sensors and pre-/post-surgical questionnaires were employed to assess intraoperative workload and to identify risk factors for surgeons using objective and subjective measures. Results Data from 49 cases (27 open and 22 laparoscopic surgeries performed by 13 male and 11 female surgeons) were assessed. More than half the surgeons reported a clinically relevant post-surgical fatigue score. The surgeons also selfreported a significant increase in pain for the neck, upper back, and lower back during/after surgery. Procedural time had significant impacts on fatigue, body part pain, and subjective (NASA-TLX) workload. The objectively assessed intraoperative work postures using wearable sensors showed a high musculoskeletal risk for neck and lower back based on their posture overall. Open surgeries had significantly larger neck angles (median [IQR]: 40 [28–47]°) compared with laparoscopic surgeries (median [IQR]: 23 [16–29]°), p 20° for neck, > 20° for torso, and > 45° for both shoulders. The procedural time for this paper is defined as the length of time between the scrub-in and scrub-out times, when the surgeon was by the bedside after patient draping and intubation. Surgical cases were then divided into shorter and longer cases at the cut-off of the median duration of the collected cases. A self-reported pain level of 3 or higher out of a maximum of 10 was considered as clinically relevant [7]. The change in ratings of fatigue and body-part specific pain after surgery was calculated as the maximum of the duringand post-surgery ratings minus the pre-surgery rating. Statistical analyses were performed using SPSS (version 26, IBM, Armonk, NY) with the statistically significant level set at α = 0.05. Procedural time between open surgery and laparoscopic surgery was compared using a Mann–Whitney U test. The proportions of clinically relevant fatigue and pain ratings were compared between the pre-surgery ratings and the maximum of the during- and post-surgery ratings using McNemar’s test for the paired proportions. Independent sample t tests were used to compare the subjective workload between shorter and longer cases. Mann–Whitney U tests were used to compare the change in fatigue and pain after surgery between the shorter and longer cases, and the objectively assessed work postures between open surgery and laparoscopic surgery.
Results A total of 4
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