Ergonomics in laparoscopy: a questionnaire survey of physical discomfort and symptoms in surgeons following laparoscopic surgery

Background:  The prolonged and frequent use of laparoscopic equipment raises ergonomic risks that may cause physical distress for surgeons. We aimed to assess the prevalence of laparoscopic surgeons’ physical distress associated with ergonomic problems in the operating room (OR) and their awareness of the ergonomic guidelines in laparoscopy. Methods: A sample of 150 laparoscopic surgeons was assessed using a questionnaire on demographic information, ergonomic issues in the OR, musculoskeletal symptoms, and awareness of the ergonomic guidelines for the OR. Results:  There were 112 survey respondents (74.3%) with valid questionnaires. Among the respondents 50% had completed laparoscopic training programs while 39.2% had no laparoscopic training. 61.5% respondents placed the operating table at umbilicus height during the actual operation. The majority of the respondents used only one monitor during the procedure. Only 4.3% placed the monitor below the eye level. 3% of the respondents attributed pain due to foot pedal design. The respondents experienced discomfort in the following regions in descending order: right shoulder (87.2%), left shoulder (78.3%), neck (67.4%), back (46.8%), hand (30.3%), leg (21.6%), and wrist (15.8%). The respondents with more than 5yrs of experience complained less discomfort than those with less than 5yrs. Only 54.6% of respondents were aware of the ergonomic guidelines. However, almost all of the respondents (100%) regarded the ergonomic guidelines to be important in the OR. Conclusions:  Most of the laparoscopic surgeons were not aware of the ergonomic guidelines for the laproscopic OR; especially, junior laparoscopic surgeons and surgeons with <5 years of laparoscopic surgical experience were more affected. They have been suffering from varying degrees of physical discomfort caused by ergonomic issues. There is an urgent need for education regarding ergonomic guidelines in the OR for laparoscopic surgeons.