The prevalence of musculoskeletal injuries in bariatric surgeons

Affiliations


Abstract

Objective: To investigate the prevalence of musculoskeletal (MSK) injuries in bariatric surgeons around the world.

Background: As the popularity of bariatric surgery increases, efforts into improving its patient safety and decreasing its invasiveness have also been on the rise. However, with this shift towards minimal invasiveness, surgeon ergonomic constraints have been imposed, with a recent report showing a 73-88% prevalence of physical complaints in surgeons performing laparoscopic surgeries.

Methods: A web-based survey was designed and sent out to bariatric surgeons around the world. Participants were queried about professional background, primary practice setting, and various issues related to bariatric surgeries and MSK injuries.

Results: There were 113 responses returned from surgeons from 34 countries around the world. 68.5% of the surgeons have had more than 10 years of experience in laparoscopic surgery, 65.8% in open, and 0.9% in robotic surgery. 66% of participants reported that they have experienced some level of discomfort/pain attributed to surgical reasons, causing the case load to decrease in 27.2% of the surgeons. It was seen that the back was the most affected area in those performing open surgery, while shoulders and back were equally as affected in those performing laparoscopic, and the neck for those performing robotic, with 29.4% of the surgeons reporting that this pain has affected their task accuracy/surgical performance. A higher percentage of females than males reported pain in the neck, back, and shoulder area when performing laparoscopic procedures. Supine positioning of patients evoked more discomfort in the wrists, while the French position caused more discomfort in the back region. A higher percentage of surgeons who did not exercise experienced more issues in the neck and back region, while those that exercised more than 3 h a week experienced issues in their shoulders and wrists in both open and laparoscopic approaches. Only 57.7% sought medical treatment for their MSK problem, of which 6.35% had to undergo surgery for their issue, of which 55.6% of those felt that the treatment resolved their problem.

Conclusion: MSK injuries and pain are a common occurrence among the population of bariatric surgeons (66%), and has the ability to hinder performance at work. Therefore, it is of importance to investigate ways in which to improve ergonomics for these surgeons as to improve quality of life.

Keywords: Bariatrics; Ergonomics; Laparoscopic surgery; Survey.


Similar articles

Operating hurts: a study of EAES surgeons.

Wells AC, Kjellman M, Harper SJF, Forsman M, Hallbeck MS.Surg Endosc. 2019 Mar;33(3):933-940. doi: 10.1007/s00464-018-6574-5. Epub 2018 Nov 19.PMID: 30456510 Free PMC article.

Survey of Canadian vascular surgeons and trainees finds work-related musculoskeletal pain and discomfort is common.

Sarwal G, Tobias G, Taylor DC, Misskey JD, Hsiang YN.J Vasc Surg. 2022 Apr;75(4):1431-1436. doi: 10.1016/j.jvs.2021.09.048. Epub 2021 Oct 28.PMID: 34718100

Comparison of postural ergonomics between laparoscopic and robotic sacrocolpopexy: a pilot study.

Tarr ME, Brancato SJ, Cunkelman JA, Polcari A, Nutter B, Kenton K.J Minim Invasive Gynecol. 2015 Feb;22(2):234-8. doi: 10.1016/j.jmig.2014.10.004. Epub 2014 Oct 12.PMID: 25315401

Review of musculoskeletal injuries and prevention in the endoscopy practitioner.

Harvin G.J Clin Gastroenterol. 2014 Aug;48(7):590-4. doi: 10.1097/MCG.0000000000000134.PMID: 24798940 Free PMC article. Review.

Surgeon Strength: Ergonomics and Strength Training in Cardiothoracic Surgery.

Dairywala MI, Gupta S, Salna M, Nguyen TC.Semin Thorac Cardiovasc Surg. 2022 Winter;34(4):1220-1229. doi: 10.1053/j.semtcvs.2021.09.015. Epub 2021 Sep 29.PMID: 34597795 Review.


Cited by

Muscle fatigue and physical discomfort reported by surgeons performing robotic-assisted surgery: a multinational survey.

Patel E, Saikali S, Mascarenhas A, Moschovas MC, Patel V.J Robot Surg. 2023 Apr 28. doi: 10.1007/s11701-023-01608-9. Online ahead of print.PMID: 37115418

Factors that make Bariatric Surgery Technically Challenging: A Survey of 370 Bariatric Surgeons.

Shahabi S, Carbajo M, Nimeri A, Kermansaravi M, Davarpanah Jazi AH, Pazouki A, Mahawar K.World J Surg. 2021 Aug;45(8):2521-2528. doi: 10.1007/s00268-021-06139-8. Epub 2021 May 1.PMID: 33934198

Pros and Cons of Robotic Revisional Bariatric Surgery.

Beckmann JH, Mehdorn AS, Kersebaum JN, von Schönfels W, Taivankhuu T, Laudes M, Egberts JH, Becker T.Visc Med. 2020 Jun;36(3):238-245. doi: 10.1159/000507742. Epub 2020 May 15.PMID: 32775356 Free PMC article.


References

  1.  
    1. Karahan A, Kav S, Abbasoglu A, Dogan N (2009) Low back pain: Prevalence and associated risk factors among hospital staff. J Adv Nurs 65:516–524 - DOI - PubMed
  2.  
    1. United States: Department of labour (2005) Labour statistics Workplace injuries and illnesses in 2005
  3.  
    1. Estimate of Bariatric Surgery Numbers, 2011–2015 (2017). American Society for Metabolic and Bariatric Surgery. N.p.
  4.  
    1. Franasiak J, Ko EM, Kidd J et al (2012) Physical strain and urgent need for ergonomic training among gynecologic oncologists who perform minimally invasive surgery. Gynecol Oncol 126:437–442 - DOI - PubMed
  5.  
    1. Park A, Lee G, Seagull FJ et al (2010) Patients benefit while surgeons suffer: an impending epidemic. J Am Coll Surg 210:306–313 - DOI - PubMed
  6.  
    1. Sari V, Nieboer TE, Vierhout ME et al (2010) The operation room as a hostile environment for surgeons: physical complaints during and after laparoscopy. Minim Invasive Ther Allied Technol 19:105–109 - DOI - PubMed
  7.  
    1. Sodergren MH, Aslanyan A, McGregor CG et al (2014) Pain, well-being, body image and cosmesis: a comparison of single-port and four-port laparoscopic cholecystectomy. Minim Invasive Ther Allied Technol 23:223–229 - DOI - PubMed
  8.  
    1. Autorino R, Stein RJ, Lima E et al (2010) Current status and future perspectives in laparoendoscopic single-site and natural orifice transluminal endoscopic urological surgery. Int J Urol 17:410–431 - DOI - PubMed
  9.  
    1. Lee G, Sutton E, Clanton T et al (2011) Higher physical workload risks with NOTES versus laparoscopy: a quantitative ergonomic assessment. Surg Endosc 25:1585–1593 - DOI - PubMed
  10.  
    1. Alleblas CC, Velthuis S, Nieboer TE et al (2015) The physical workload of surgeons: a comparison of SILS and conventional laparoscopy. Surg Innov 22:376–381 - DOI - PubMed
  11.  
    1. Koca D, Yildiz S, Soyupek F et al (2015) Physical and mental workload in singleincision laparoscopic surgery and conventional laparoscopy. Surg Innov 22:294–302 - DOI - PubMed
  12.  
    1. Zihni AM, Ohu I, Cavallo JA et al (2014) Ergonomic analysis of robot-assisted and traditional laparoscopic procedures. Surg Endosc 28:3379–3384 - DOI - PubMed
  13.  
    1. Lawson EH, Curet MJ, Sanchez BR et al (2007) Postural ergonomics during robotic and laparoscopic gastric bypass surgery: a pilot project. J Robot Surg 1:61–67 - DOI - PubMed - PMC
  14.  
    1. Luxembourg: EC (2004) European Communities Work and health in the EU, a statistical portrait
  15.  
    1. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, Jørgensen K (1987) Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 18(3):233–237 - DOI - PubMed
  16.  
    1. Lester JD, Hsu S, Ahmad CS (2012) Occupational hazards facing orthopedic surgeons. Am J Orthop 41(3):132–139 - PubMed
  17.  
    1. Mirbod SM, Yoshida H, Miyamoto K, Miyashita K, Inaba R, Iwata H (1995) Subjective complaints in orthopedists and general surgeons. Int Arch Occup Environ Health 67(3):179–186 - PubMed
  18.  
    1. Auerbach JD, Weidner ZD, Milby AH, Diab M, Lonner BS (2011) Musculoskeletal disorders among spine surgeons: results of a survey of the Scoliosis Research Society membership. Spine 36(26):1715–1721 - DOI
  19.  
    1. Alleblas CCJ, De Man AM, Van Den Haak L, Vierhout ME, Jansen FW, Nieboer TE (2017) Prevalence of musculoskeletal disorders among surgeons performing minimally invasive surgery. Ann Surg 266:905–920. Web - DOI - PubMed
  20.  
    1. Kolfschoten NE, van Leersum NJ, Gooiker GA et al (2013) Successful and safe introduction of laparoscopic colorectal cancer surgery in Dutch hospitals. Ann Surg 257:916–921 - DOI
  21.  
    1. Keus F, de Jong JA, Gooszen HG et al (2006) Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev 4:CD006231
  22.  
    1. Sauerland S, Jaschinski T, Neugebauer EA (2010) Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 10:CD001546
  23.  
    1. Plerhoples TA, Hernandez-Boussard T, Wren SM (2012) The aching surgeon: a survey of physical discomfort and symptoms following open, laparoscopic and robotic surgery. J Robot Surg 6:65–72 - DOI - PubMed
  24.  
    1. Santos-Carreras L, Hagen M, Gassert R et al (2012) Survey on surgical instrument handle design: ergonomics and acceptance. Surg Innov 19:50–59 - DOI - PubMed
  25.  
    1. Giberti C, Gallo F, Francini L et al (2014) Musculoskeletal disorders among robotic surgeons: a questionnaire analysis. Arch Ital Urol Androl 86:95–98 - DOI - PubMed
  26.  
    1. Krantz G, Berntsson L, Lundberg U (2005) Total workload, work stress and perceived symptoms in Swedish male and female white-collar employees. Eur J Public health 15:209–214 - DOI - PubMed
  27.  
    1. Adams SR, Hacker MR, McKinney JL et al (2013) Musculoskeletal pain in gynecologic surgeons. J Minim Invasive Gynecol 20:656–660 - DOI - PubMed
  28.  
    1. Ruitenburg MM, Frings-Dresen MH, Sluiter JK (2013) Physical job demands and related health complaints among surgeons. Int Arch Occup Environ Health 86:271–279 - DOI - PubMed
  29.  
    1. Esposito C, Najmaldin A, Schier F et al (2014) Work-related upper limb musculoskeletal disorders in pediatric minimally invasive surgery: a multicentric survey comparing laparoscopic and sils ergonomy. Pediatr Surg Int 30:395–399 - DOI - PubMed