Ergonomics in surgical instrumentation

Ergonomía en instrumentación quirúrgica

The ergonomics of surgical instrumentation professionals in surgical wards is described, due to the scarce information available. The bibliographic review was based on the data obtained with the keywords and Boolean operators. There were 51 references, 39 of the last ten years. The literature recognizes the ergonomic work risk of instrumentation and points out some elements of the operating room as possible risk factors. The activity assistance in surgery is when more harmful postures are generated, associating some surgical specialties with postural stress and especially in laparoscopic ones. The most frequent musculoskeletal symptoms are identified in the work performance as well as their possible causes, making the appropriate preventive recommendations to improve the ergonomics of these professionals in surgery rooms. Abbreviations: IQ, surgical instrumentation, surgical instrumentation; RL, occupational risks.

1. Guillen M. Ergonomía y la relación con los factores de riesgo en salud ocupacional. Rev cubana enfermer. 2006 Dic; 22(4).

2. Vieira ER, Kumar S. Working postures: a literature review.J Occup Rehabil. 2004 Jun; 14(2):143-59.

3. Nogareda S, Dalmau I. NTP 452: evaluación de las condiciones de trabajo: carga postural.Madrid, España: INSHT;1997.

4. Kant IJ, de Jong LC, van Rijssen-Moll M, Borm PJ. A survey of static and dynamic work postures of operating room staff. Int Arch Occup Environ Health. 1992; 63(6):423-8.

5. Morán CJ. Occupational hazards of professional nursing in Hospital Sergio E. Bernales - Collique operating rooms, February-August 2009. Rev Per Obst Enf. 2009; 5(2):104-9.

6. Matern U, Koneczny S. Safety, hazards and ergonomics in the operating room. SurgEndosc.2007 Nov; 21(11):1965-9.

7. Berguer R. Surgery and ergonomics. Arch Surg. 1999 Sep; 134(9):1011-6.

8. Van Veelen MA, Nederlof EA, Goossens RH, Schot CJ, Jakimowicz JJ. Ergonomic problems encountered by the medical team related to products used for minimally invasive surgery. Surg Endosc. 2003 Jul; 17(7):1077-81.

9. Gerbrands A, Albayrak A, Kazemier G. Ergonomic evaluation of the work area of the scrub nurse. Minim Invasive Ther Allied Technol. 2004 Jun; 13(3):142-6.

10. VilelaJA, Diaz T, Sanfeliz A.Analisis ergonomico en enfermeria instrumentista: un enfoque descriptivo. Seguridad y salud en el trabajo. 2003; 24:5-10.

11. Kułagowska E. Musculoskeletal system load in operating room nurses and its determinants. Med Pr. 2009; 60(3):187-95.

12. Mirbod SM, Yoshida H, Miyamoto K, Miyashita K, Inaba R, Iwata H. Subjective complaints in orthopedists and general surgeons. Int Arch Occup Environ Health. 1995; 67(3):179-86.

13. Engels JA, Landeweerd JA, Kant Y. An OWAS-based analysis of nurses’ working postures. Ergonomics. 1994 May; 37(5):909-19.

14. Idoate VM, Bravo B, Guergue MC, Berraondo J, Sagues N, Mendaza I. Procesos pelvianos periarticulares en instrumentistas de quirófano. Arch Prev Riesgos Labor. 2002; 5(2):48-52.

15. Vereczkei A, Feussner H, Negele T, Fritzsche F, Seitz T, Bubb H, Horváth OP. Ergonomic assessment of the static stress confronted by surgeons during laparoscopic cholecystectomy. Surg Endosc. 2004 Jul; 18(7):1118-22.

16. Van Veelen MA, Jakimowicz JJ, Kazemier G. Improved physical ergonomics of laparoscopic surgery. Minim Invasive Ther Allied Technol. 2004 Jun; 13(3):161-6.

17. Sari V, Nieboer TE, Vierhout ME, Stegeman DF, Kluivers KB. The operation room as a hostile environment for surgeons: physical complaints during and after laparoscopy. Minim Invasive Ther Allied Technol. 2010 Apr; 19(2):105-9.

18. Van Det MJ, Meijerink WJ, Hoff C, van Veelen MA, Pierie JP. Ergonomic assessment of neck posture in the minimally invasive surgery suite during laparoscopic cholecystectomy. Surg Endosc. 2008 Nov; 22(11):2421-7.

19. Seghers J, Jochem A, Spaepen A. Posture, muscle activity and muscle fatigue in prolonged VDT work at different screen height settings. Ergonomics. 2003 Jun 10; 46(7):714-30.

20. Van Det MJ, Meijerink WJ, Hoff C, Totté ER, Pierie JP. Optimal ergonomics for laparoscopic surgery in minimally invasive surgery suites: a review and guidelines. Surg Endosc. 2009 Jun; 23(6):1279-85.

21. Szeto GP, Ho P, Ting AC, Poon JT, Tsang RC, Cheng SW. A study of surgeons’ postural muscle activity during open, laparoscopic, and endovascular surgery. Surg Endosc. 2010 Jul; 24(7):1712-21.

22. Matern U. Ergonomic deficiencies in the operating room: examples from minimally invasive surgery. Work. 2009; 33(2):165-8.

23. Papp A, Feussner H, Seitz T, Bubb H, Schneider A, Horvath OP, Vereczkei A. Ergonomic evaluation of the scrub nurse’s posture at different monitor positions during laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2009 Apr; 19(2):165-9.

24. Nguyen NT, Ho HS, Smith WD, Philipps C, Lewis C, De Vera RM, Berguer R. An ergonomic evaluation of surgeons’ axial skeletal and upper extremity movements during laparoscopic and open surgery. Am J Surg. 2001 Dec; 182(6):720-4.

25. Berquer R, Smith WD, Davis S. An ergonomic study of the optimum operating table height for laparoscopic surgery. Surg Endosc. 2002 Mar; 16(3):416-21.

26. Manasnayakorn S, Cuschieri A, Hanna GB. Ergonomic assessment of optimum operating table height for hand-assisted laparoscopic surgery. SurgEndosc. 2009 Apr; 23(4):783-9. Epub 2008 Jul 16.

27. Wauben LS, van Veelen MA, Gossot D, Goossens RH. Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284surgeons.SurgEndosc. 2006 Aug; 20(8):1268-74.

28. Berguer R, Rab GT, Abu-Ghaida H, Alarcon A, Chung J. A comparison of surgeons’ posture during laparoscopic and open surgical procedures. Surg Endosc. 1997 Feb; 11(2):139-42.

29. Berguer R, Forkey DL, Smith WD. Ergonomic problems associated with laparoscopic surgery. Surg Endosc. 1999 May; 13(5):466-8.

30. Hemal AK, Srinivas M, Charles AR. Ergonomic problems associated with laparoscopy. J Endourol. 2001 Jun; 15(5):499-503.

31. Supe AN, Kulkarni GV, Supe PA. Ergonomics in laparoscopic surgery. J Minim Access Surg. 2010 Apr; 6(2):31-6.

32. Reddy PP, Reddy TP, Roig-Francoli J, Cone L, Sivan B, DeFoor WR, Gaitonde K, Noh PH. The impact of the alexander technique on improving posture and surgical ergonomics during minimally invasive surgery: pilot study. J Urol. 2011 Oct; 186(4 Suppl):1658-62.

33. Klein M, Andersen LP, Alamili M, Gögenur I, Rosenberg J. Psychological and physical stress in surgeons operating in a standard or modern operating room. Surg Laparosc Endosc Percutan Tech. 2010 Aug; 20(4):237-42.

34. Liang CA, Levine VJ, Dusza SW, Hale EK, Nehal KS. Musculoskeletal disorders and ergonomics in dermatologic surgery: a survey of Mohs surgeons in 2010. Dermatol Surg. 2012 Feb; 38(2):240-8.

35. Meijsen P, Knibbe HJ. Work-related musculoskeletal disorders of perioperative personnel in the Netherlands. AORN J. 2007 Aug; 86(2):193-208.

36. Szeto GP, Ho P, Ting AC, Poon JT, Cheng SW, Tsang RC. Work-related musculoskeletal symptoms in surgeons.J Occup Rehabil. 2009 Jun; 19(2):175-84.

37. Bos E, Krol B, van der Star L, Groothoff J. Risk factors and musculoskeletal complaints in non-specialized nurses, IC nurses, operation room nurses, and X-ray technologists.Int Arch Occup Environ Health. 2007 Jan; 80(3):198-206.

38. Chan OY, Ho SF. Study on musculoskeletal complaints involving the back, neck and upper limbs. Singapore Med J.1998 Aug; 39(8):363-7.

39. Das B, Sengupta AK. Evaluation of low back pain risks in a beef skinning operation. Int J Occup Saf Ergon. 2000; 6(3):347-61.

40. Toffola ED, Rodigari A, Di Natali G, Ferrari S, Mazzacane B. Posture and fatigue among surgeons in the operating room. G Ital Med Lav Ergon. 2009 Oct-Dec; 31(4):414-8.

41. Yip VY. New low back pain in nurses: work activities, work stress and sedentary lifestyle. J Adv Nurs. 2004 May; 46(4):430-40.

42. Freitag S, Ellegast R, Dulon M, Nienhaus A. Quantitative measurement of stressful trunk postures in nursing professions. Ann Occup Hyg. 2007 Jun; 51(4):385-95.

43. Hansson T, Jensen I. Swedish Council on Technology Assessment in HealthCare (SBU). Chapter6. Sickness absence due to back and neck disorders. Scand J Public Health Suppl. 2004; 63:109-51.

44. Sheikhzadeh A, Gore C, Zuckerman JD, Nordin M. Perioperating nurses and technicians’ perceptions of ergonomic risk factors in the surgical environment. Appl Ergon. 2009 Sep; 40(5):833-9.

45. Engels JA, van der Gulden JW, Senden TF, van’t Hof B.Work related risk factors for musculoskeletal complaints in the nursing profession: results of a questionnaire survey. Occup Environ Med. 1996 Sep; 53(9):636-41.

46. Karahan A, Kav S, Abbasoglu A, Dogan N. Low back pain: prevalence and associated risk factors among hospital staff. J Adv Nurs. 2009 Mar; 65(3):516-24.

47. Walker-Bone K, Cooper C. Hard work never hurt anyone--or did it? A review of occupational associations with soft tissue musculoskeletal disorders of the neck and upper limb. Ann Rheum Dis. 2005 Aug; 64(8):1112-7.

48. Stock SR. Work place ergonomic factors and the development of musculoskeletal disorders of the neck and upper limbs: a meta-analysis. Am J Ind Med. 1991; 19(1):87-107.

49. Latko WA, Armstrong TJ, Franzblau A, Ulin SS, Werner RA, Albers JW. Crosssectional study of the relationship between repetitive work and the prevalence of upper limb musculoskeletal disorders. Am JInd med. 1999 Aug; 36(2):248-59.

50. Van Rijn RM, Huisstede BM, Koes BW, Burdorf A. Associations between workrelated factors and specific disorders at the elbow: a systematic literature review. Rheumatology (Oxford). 2009 May; 48(5):528-36.

51. Hull L, Arora S, Kassab E, Kneebone R, Sevdalis N. Assessment of stress and teamwork in the operating room: an exploratory study. Am J Surg. 2011 Jan; 201(1):24-30.