Presented by: Eric J Regele MD
Mayo Clinic Florida

Introduction

Ergonomic impact on surgeon longevity and surgeon well-being is understudied. Like other physically demanding jobs, surgery can have a significant impact on surgeon wellbeing, occupational longevity, and economics. This study aims to characterize the impact of ergonomics on pelvic surgeons.  

Materials

A tri-site (Mayo Clinic Arizona, Florida & Rochester) internal survey was sent to all pelvic surgeons at a single enterprise. A total of 129 surgeons received an electronic anonymous survey-based questionnaire characterizing ergonomic impact on surgeon wellbeing.

Results

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Of 129 surveys provided, 48 (32.1%) responses were completed (62.5% male, 37.5% female). Mean age, career duration, and BMI were 48.1 years old, 13.3 years, and 25.5, respectively. 39.6% were urologists, 45.8% gynecologists, and 14.6% colorectal surgeons. Dominant modality with respect to surgical approach was defined as the approach where > 10 % of all surgeries were performed. The cohorts were as follows: 25% open, 18.6% robotic, 18.6% endoscopic, 14.6% laparoscopic, 16.7% had no dominant modality, and 6.3% vaginal/hysteroscopic. Average OR days/week were 2.1 and percentage of cases  >3 hours were 35.5%. Twenty five percent of surgeons had baseline pain not attributed to surgery, and 100% reported acute on chronic pain exacerbation with surgery. On a scale of 1 (least) to 10 (greatest), open surgery on average was reported as the most physically demanding (6.10), followed by laparoscopy (5.55), endoscopy (3.72), and robotics (3.69). Figure 1 shows surgeon reported musculoskeletal (MSK) pain by dominant surgical modality. With the exception of endoscopic surgery (30-60 min), surgical approach was irrespective of onset of pain (1-2 hrs). 50% of pelvic surgeons noted pain will influence their ability to perform future surgery.

 

Conclusion

Ergonomics play an impactful role on surgeon wellbeing and ability to perform future surgery. 1 in 2 pelvic surgeons will report MSK pain attributed to surgery. On average, pelvic surgeons associate open and laparoscopic surgery as the most physically demanding. However, surgeons who perform robotic surgery report no MSK pain attributed to surgery. A rise in minimally invasive alternatives to open surgery may be an untoward benefit to surgeon longevity.

Funding

None

Lead Authors

Raymond Pak, MD, MBA
Mayo Clinic Florida

Co-Authors

Ram A Pathak, MD
Mayo Clinic Florida

Hamid Norasi, PhD
Mayo Clinic Rochester

M Susan Hallbeck, PhD
Mayo Clinic Rochester

Eric A V Qualkenbush, MD
Mayo Clinic Florida