Injuries from Minimally Invasive Techniques -- MEDICA - World Forum for Medicine

Injuries from Minimally Invasive Techniques

The survey found that 87 percent of laparoscopic surgeons have experienced physical symptoms or discomfort. Previous surveys had found only a 20 to 30 percent incidence of occupational injury among these surgeons. "We face a pending epidemic of occupational injuries to surgeons and we can no longer ignore their safety and health," says the survey's principal author, Adrian E. Park.

Park says surgeons who perform laparoscopic surgery face constraints that are not part of open surgery. "With laparoscopic surgery, we operate by looking at a video screen, often keeping our neck and posture in an awkward position for hours," says Park. "Also, we are standing for extended periods of time with our shoulders up and our arms out, holding and maneuvering long instruments through tiny, fixed ports."

A 23-question survey was sent to 2,000 gastrointestinal and endoscopic surgeons, a diverse group of experienced laparoscopic practitioners. Of 317 surgeons completing the survey, 272 (86.9 percent) reported experiencing physical discomfort or symptoms they attributed to performing minimally invasive surgery. The discomfort ranged from eye strain to problems in the surgeon's dominant hand, to neck, back and leg pain. A few surgeons also reported headaches, finger calluses, disc problems, shoulder muscle spasm and carpel tunnel syndrome.

Annual case volume emerged as a key predictor of physical symptoms. Case volume impact was seen in surgeons who had received postgraduate surgical fellowship training. Those surgeons averaged 249 cases a year, while the non-fellowship average was 192. Neck, hand and leg symptoms rose with increased case volume. Significantly, 40 percent of all participants said they would just ignore any such problem.

Instrument design was listed as the main source of symptoms for more than 74 percent of the surgeons, while 40 percent cited operating room table setup and display monitor location. More than half of the surgeons said they were only slightly aware or not aware at all of recommendations to reduce symptoms from researchers in the field of surgical ergonomics.; Source: University of Maryland Medical Center