Surgery
Tackling injury risk linked to lack of ergonomics
Is there an issue with ergonomics in surgery and can instrument design help take the strain? Michael Parden highlights the importance of preventing musculoskeletal pain and injury within the surgical community.
As the surgical community becomes increasingly diverse, there is growing evidence that a one-size-fits-all approach to surgical instrument design is contributing to the rising physical and mental toll1
of unergonomic
operating theatres. A growing body of recent research is shining
a spotlight on the prevalence of physical injuries faced by the surgical community in general, and within orthopaedic surgery in particular. A 2021 survey2
injury across all surgical specialties found that pain and disability induced by poor ergonomics are widespread. Of the 167 respondents, 69.7% reported suffering from musculoskeletal (MSK) pain, 54.9% of the surgeons reported suffering from the highest level of pain when standing during surgery, while only 14.4% experienced pain when sitting.
Importantly, 47.7% stated the pain impacted their work, while 59.5% reported pain affecting their quality of life outside of work.
looking at the risk of ergonomic
The problem is particularly acute for orthopaedic surgeons who work in an environment that puts a high demand on their bodies, especially the musculoskeletal system. Repetitive movements while using tools, prolonged standing, and operating in sustained, non-ergonomic positions, all contribute to this increased load on the bones and muscles. This is reflected in a much greater prevalence of MSK pain experienced by the orthopaedic community. On average, 44% to 55 % of orthopaedic
surgeons suffer from work-related MSK disorders3 survey4
and, in one 2021 multi-centre US , 97 % of orthopaedic surgery resident
respondents reported experiencing procedural- related MSK pain. The high cost of management and
rehabilitation of these injuries – in addition to the related number of missed workdays – highlights the need for increased awareness and implementation of preventative measures. Another study has shown an increased incidence of musculoskeletal complaints in
orthopaedic surgeons compared with other specialties. A total of 86 surgeons completed a survey during the period of data collection. Overall, 66.7% of responding surgeons
reported a work-related MSK disorder of which 26.7% required time off work because of their injuries. The graph (figure 1) shows the types of injuries suffered.5
Are instruments designed for our diverse surgical community? Indeed, the issue was highlighted in the Royal College of Surgeons of England (RCS England) November 2022 Bulletin6
which stressed the
need to address a continued one-size-fits- all approach to instrument design - despite growing diversity in the surgeon workforce. In 1991, only 3% of the surgical consultant body were women.7
A 2021 study8 found that MSK injury rates
among surgeons are higher in women. Female orthopaedic surgeons are more likely than their male counterparts to report physical symptoms attributed to orthopaedic surgical instruments, to have negative attitudes to instruments, and to identify a larger number of common instruments as difficult or uncomfortable to use. The research involved a survey of 204 trainee orthopaedic surgeons, of which 119 were female. It revealed higher numbers of female surgeons felt surgical instruments did not fit their hands comfortably, were not designed for surgeons of their hand size or structure, put them at increased risk of injury, limited their technical abilities, and should be available in more sizes. David J. O’Regan, visiting professor at department of surgery and cancer, Faculty of Medicine, Imperial College & Founder of Black Belt Academy of Surgical Skills (BBASS), said: “Good surgeons respect the tissues because
they can ‘feel’ the tissues. The Black Belt Academy of Surgical Skills teaches respect for and proper handling of surgical instruments. The instrument is an extension of the hand, and
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www.clinicalservicesjournal.com I March 2023
This had risen to 16% in 2020,
with more than a third (34%) of registrars being female.
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