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Patients benefit while surgeons suffer: an impending epidemic.
J Am Coll Surg. 2010 Mar; 210(3):306-13.JA

Abstract

BACKGROUND

The widely held belief that laparoscopy causes greater strain on surgeons' bodies than open surgery is not well documented in scope or magnitude. In the largest North American survey to date, we investigated the association of demographics, ergonomics, and environment and equipment with physical symptoms reported by laparoscopic surgeons.

STUDY DESIGN

There were 317 surgeons identified as involved in laparoscopic practices who completed the online survey. Data collected from this comprehensive 23-question survey were analyzed using chi-square.

RESULTS

There were 272 laparoscopic surgeons (86.9%) who reported physical symptoms or discomfort. The strongest predictor of symptoms was high case volume, with the surprising exceptions of eye and back symptoms, which were consistently reported even with low case volumes. High rates of neck, hand, and lower extremity symptoms correlated with fellowship training, which is strongly associated with high case volume. Surprisingly, symptoms were little related to age, height, or practice length. The level of surgeons' awareness of ergonomic guidelines proved to be somewhere between slightly and somewhat aware. A substantial number of respondents requested improvements in regard to both the positioning and resolution of the monitor.

CONCLUSIONS

Far beyond previous reports of 20% to 30% incidence of occupational injury, we present evidence that 87% of surgeons who regularly perform minimally invasive surgery suffer such symptoms or injuries, primarily high case load-associated. Additional data accrual and analysis are necessary, as laparoscopic procedures become more prevalent, for improvement of surgeon-patient and surgeon-technology interfaces to reverse this trend and halt the epidemic before it is upon us.

Authors+Show Affiliations

Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201-1595, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20193893

Citation

Park, Adrian, et al. "Patients Benefit While Surgeons Suffer: an Impending Epidemic." Journal of the American College of Surgeons, vol. 210, no. 3, 2010, pp. 306-13.
Park A, Lee G, Seagull FJ, et al. Patients benefit while surgeons suffer: an impending epidemic. J Am Coll Surg. 2010;210(3):306-13.
Park, A., Lee, G., Seagull, F. J., Meenaghan, N., & Dexter, D. (2010). Patients benefit while surgeons suffer: an impending epidemic. Journal of the American College of Surgeons, 210(3), 306-13. https://doi.org/10.1016/j.jamcollsurg.2009.10.017
Park A, et al. Patients Benefit While Surgeons Suffer: an Impending Epidemic. J Am Coll Surg. 2010;210(3):306-13. PubMed PMID: 20193893.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patients benefit while surgeons suffer: an impending epidemic. AU - Park,Adrian, AU - Lee,Gyusung, AU - Seagull,F Jacob, AU - Meenaghan,Nora, AU - Dexter,David, Y1 - 2009/12/24/ PY - 2009/09/12/received PY - 2009/10/22/revised PY - 2009/10/27/accepted PY - 2010/3/3/entrez PY - 2010/3/3/pubmed PY - 2010/4/16/medline SP - 306 EP - 13 JF - Journal of the American College of Surgeons JO - J Am Coll Surg VL - 210 IS - 3 N2 - BACKGROUND: The widely held belief that laparoscopy causes greater strain on surgeons' bodies than open surgery is not well documented in scope or magnitude. In the largest North American survey to date, we investigated the association of demographics, ergonomics, and environment and equipment with physical symptoms reported by laparoscopic surgeons. STUDY DESIGN: There were 317 surgeons identified as involved in laparoscopic practices who completed the online survey. Data collected from this comprehensive 23-question survey were analyzed using chi-square. RESULTS: There were 272 laparoscopic surgeons (86.9%) who reported physical symptoms or discomfort. The strongest predictor of symptoms was high case volume, with the surprising exceptions of eye and back symptoms, which were consistently reported even with low case volumes. High rates of neck, hand, and lower extremity symptoms correlated with fellowship training, which is strongly associated with high case volume. Surprisingly, symptoms were little related to age, height, or practice length. The level of surgeons' awareness of ergonomic guidelines proved to be somewhere between slightly and somewhat aware. A substantial number of respondents requested improvements in regard to both the positioning and resolution of the monitor. CONCLUSIONS: Far beyond previous reports of 20% to 30% incidence of occupational injury, we present evidence that 87% of surgeons who regularly perform minimally invasive surgery suffer such symptoms or injuries, primarily high case load-associated. Additional data accrual and analysis are necessary, as laparoscopic procedures become more prevalent, for improvement of surgeon-patient and surgeon-technology interfaces to reverse this trend and halt the epidemic before it is upon us. SN - 1879-1190 UR - https://www.unboundmedicine.com/medline/citation/20193893/Patients_benefit_while_surgeons_suffer:_an_impending_epidemic_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1072-7515(09)01550-6 DB - PRIME DP - Unbound Medicine ER -