Review2017

Prevalence of Musculoskeletal Disorders Among Surgeons Performing Minimally Invasive Surgery

Chantal C. J. Alleblas · Anne Marie de Man · Lukas van den Haak · Mark Ewout Vierhout · Frank Willem Jansen · Theodoor Elbert Nieboer

130 citations0/0 files storedAnnals of Surgery

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Ergonomics and Musculoskeletal Disorders Occupational Health and Safety in Workplaces Occupational health in dentistry

Abstract

OBJECTIVE: The aim of this study was to review musculoskeletal disorder (MSD) prevalence among surgeons performing minimally invasive surgery. BACKGROUND: Advancements in laparoscopic surgery have primarily focused on enhancing patient benefits. However, compared with open surgery, laparoscopic surgery imposes greater ergonomic constraints on surgeons. Recent reports indicate a 73% to 88% prevalence of physical complaints among laparoscopic surgeons, which is greater than in the general working population, supporting the need to address the surgeons' physical health. METHODS: To summarize the prevalence of MSDs among surgeons performing laparoscopic surgery, we performed a systematic review of studies addressing physical ergonomics as a determinant, and reporting MSD prevalence. On April 15 2016, we searched Pubmed, EMBASE, the Cochrane Library, Web of Science, CINAHL, and PsychINFO. Meta-analyses were performed using the Hartung-Knapp-Sidik-Jonkman method. RESULTS: We identified 35 articles, including 7112 respondents. The weighted average prevalence of complaints was 74% [95% confidence interval (95% CI) 65-83]. We found high inconsistency across study results (I = 98.3%) and the overall response rate was low. If all nonresponders were without complaints, the prevalence would be 22% (95% CI 16-30). CONCLUSIONS: From the available literature, we found a 74% prevalence of physical complaints among laparoscopic surgeons. However, the low response rates and the high inconsistency across studies leave some uncertainty, suggesting an actual prevalence of between 22% and 74%. Fatigue and MSDs impact psychomotor performance; therefore, these results warrant further investigation. Continuous changes are enacted to increase patient safety and surgical care quality, and should also include efforts to improve surgeons' well-being.

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References

2007The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies 2007Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration 1987Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms 2014The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard DerSimonian-Laird method 2015Exploring physician specialist response rates to web-based surveys 2009Patients Benefit While Surgeons Suffer: An Impending Epidemic 1999Ergonomic problems associated with laparoscopic surgery 2009Work-related Musculoskeletal Symptoms in Surgeons

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