番茄社区

Surgeons spent most of their time during operations forcing their bodies into bad postures, wearable sensors confirmed.

When 53 participating surgeons had postural sensors placed on the head, torso, and upper arms during cases, the proportion of procedure time spent in high risk positions was:

• 65% for the neck
• 30% for the torso
• 11% for the shoulders

The sensors -- each with an accelerometer, magnetometer, and gyroscope -- allowed for continuous recording and measurement of deviations from neutral body position, as researchers led by Andrew Meltzer, MD, MBA, of Mayo Clinic in Phoenix, Arizona, reported online in .

"Ergonomists have long recognized the potential hazards facing the surgeon; from the ergonomic standpoint, surgery has been described as 'a mess,'" the authors noted.

"The physical demands of performing surgery are real. A surgeon's cervical spine, in particular, is at unacceptably elevated risk during many procedures. Poor ergonomics are a cause of for many surgeons, reducing career longevity and threatening the public's access to surgical care," they said.

Importantly, the findings showed that wearable technology can be used "to assess surgeons' intraoperative ergonomics and postural behavior, providing an evidence base and method for future objective research in this area," Meltzer's team said.

This really was the novelty of the study -- a way to bring wearable technology into the operating room for good ergonomic data without it being particularly cumbersome, according to Adrian Park, MD, of Anne Arundel Medical Center in Annapolis, Maryland, and Johns Hopkins University School of Medicine in Baltimore, who was not involved with the study.

"Historically, if you wanted to comment on ergonomic risk factor violation and ergonomically suboptimal posture and movement, we had to have these elaborate motion capture systems, and various things like that are hard to set up in a sterile environment," Park told 番茄社区 in a phone interview.

In one sense, surgeons may be "late to the game" when it comes to using wearables, Park said. "Even though the operating room is one of the most high-tech and important working spaces that humans occupy, we actually lag in many ways the adoption of technologies that come to other working environments."

On the other hand, he noted, "we have understandable barriers to bringing anything into the perioperative environment."

For the study, 53 participating surgeons from 12 surgical specialties were observed over 115 cases. This group averaged age 45, and 35.8% were women.

Open surgeries were particularly risky in terms of the surgeon's time spent with the neck in a bad ergonomic position (adjusted OR 31.1 compared with , 95% CI 8.47-114.41).

Adjunctive equipment was also associated with longer periods with poor neck placement, namely surgical loupes (85.2% of procedure time vs 58.1% without loupes, P<0.007) and headlamps (79.9% vs 62.2%, P=0.02).

Surgeons tended to report more pain if they were working longer cases, had more years of practice under their belt, and were using loupes and headlights. In turn, surgeon self-reported pain tended to correlate with ergonomic risk, Meltzer and colleagues found.

Major limitations were the study's small sample and its inherent possibility of selection bias.

Comment