Author |
Study Population, Sample Size, and Response Rate |
Type of Surgery |
Tool |
Results |
Adams et al31 |
Sample: 7715 members of the AAGL and past attendees of the Surgical Film Festival Response rate: 4% (495/7715) |
Benign, obstetric, and oncological surgery (27 5%) of respondents were minimally invasive gynecological surgeons) |
Self-composed questionnaire including modified Standardized Nordic Musculoskeletal Questionnaire |
Primary outcome: 12-month prevalence of pain (daily pain) Lower back: 75.6% (7.9%) Neck pain: 72.9% (11 3%) Shoulder pain: 66.6% (3%) Upper back pain: 61.6% (9%) Wrist/hand pain: 60.9% (1%) |
Other relevant outcomes: 76.3–82.7% (depending on region) believed that performing surgery caused or worsened the pain 11.6% admitted they had decreased their surgical practise due to injury or pain 34.8% believed their surgical performance was affected by injury or pain Women show an approximately 2-fold higher risk of pain in the lower back, upper back, and hand/wrist region |
Bagrodia and Raman54 |
Sample: 1275 Urologists of the Endourologic Society and the Society of Urologic Oncology Response rate: 8.3% (106/1275) |
Open, laparoscopic, and robot-assisted prostatectomy |
Self-composed questionnaire |
Primary outcome: Prevalence of chronic back or neck pain: 43% |
Other relevant outcomes: 50% of those who reported chronic pain said operating caused or exacerbated pain 25% of those who reported chronic pain said it impacted their choice of operative approach Neck and/or back pain was experienced in 50% 56% and 23% of surgeons after open, laparoscopic, and robot-assisted prostatectomy, respectively |
Berguer and Hreljac42 |
Sample: 11, 000 Laparoscopic surgeons members of SAGES, AAGL, and AWS Response rate: 6.7% (726/10835) |
Laparoscopic surgery |
Self-composed questionnaire |
Primary outcome: 20% (P = 145) reported musculoskeletal problems |
Other relevant outcomes: Subjects who reported musculoskeletal problems performed significantly greater proportions of laparoscopic procedures (0.01) Respondents with small glove size had more difficulty using all laparoscopic instruments compared to the respondents with medium and large glove size (0.001) |
Berguer et al35, 39 |
Sample: ~800 SAGES conference visitors Response rate: 18.6% (149/800) |
Laparoscopic surgery |
Self-composed questionnaire (developed by SAGES Task Force on Ergonomics) |
Primary outcome: prevalence of pain/stiffness, further subdivided into Neck pain: 52% (43%) occasionally; 9% frequently) Neck stiffness: 62% (44%) occasionally; 18% frequently) Shoulder/arm pain: 55% (43%) occasionally; 12% frequently) Shoulder/arm stiffness: 50% (39%) occasionally; 11% frequently) Hand/wrist pain: 47% (36%) occasionally; 11% frequent) |
Cass et al 43 |
Sample: 506 gynecologists (members of the British Society of Gynecological Endoscopy) Response rate: 25.3% (128/506) |
Laparoscopic surgery |
Self-composed questionnaire |
Primary outcome: 99% (127/128) ever reported pain/stiffness directly attributable to laparoscopy, further subdivided into Shoulder pain/stiffness: 80% (52%) occasionally; 28% frequently) Neck pain/stiffness: 74% (56%) occasionally; 17% frequently) Back pain/stiffness: 77% (54%) occasionally; 22% frequently) Hand pain/stiffness: 70% (56%) occasionally; 14% frequently) |
Other relevant outcomes: Vertebral disc prolapse was diagnosed in 15% (19/128) of respondents; 11 were located in the lumbar region and 32% (6/19) needed definitive treatment Injury of disc prolapse was significantly associated with hours worked per week (P = 0.005) years of laparoscopic practice (0.001) more complex surgery (P = 0.039) and difficulty manipulating laparoscopic instruments (P = 0.034) |
Esposito et al55 |
Sample: 25 pediatric laparoscopists Response rate: 92% (23/25) |
Pediatric laparoscopic and open surgery |
Self-composed questionnaire |
Primary outcome: 78% (18/23) of surgeons that performed laparoscopy for more than 10 years reported shoulder symptoms; 61% (14/23) reported symptoms in the neck, elbow, and/or wrist (14/23) |
Other relevant outcomes: 44% (8/18) of surgeons required painkillers at least twice week 17% (3/18) reported that their pain influenced their surgical activity |
Esposito et al44 |
Sample: 14 pediatric laparoscopists Response rate: 100% (14/14) |
Conventional laparoscopy (CLS, n = 7) and SILS (n = 7) |
Self-composed questionnaire |
Primary outcome: 57% (8/14) reported musculoskeletal disorders: in SILS, in CLS |
Other relevant outcomes: All musculoskeletal disorders after laparoscopy were located in the shoulder 75% (3/4) of musculoskeletal disorders after SILS were located in the shoulder and 25% (1/4) in the back 75% (3/4) of SILS surgeons who reported musculoskeletal disorders used painkillers 1–times week versus 25% in the laparoscopic group All SILS surgeons reported that SILS has bad ergonomics for surgeons compared with CLS 25% (2/8) reported that their pain influences their surgical activity: in SILS, in CLS |
Filisetti et al45 |
Sample: unknown Response: 138 |
Pediatric laparoscopic surgery |
|
Primary outcome: 45% (62/138) reported musculoskeletal problems and 17 surgeons complained about musculoskeletal problem Overall, back pain was the main problem reported (18 1%; 25/138) |
Franasiak et al18 |
Sample: 833 gynecologic oncologists (members of the SGO) Response rate: 31.2% (260/833) |
Open, laparoscopic, and robotic surgery |
Self-composed questionnaire |
Primary outcome: 88% (216/244) of surgeons reported physical discomfort related to MIS, with 52% reporting persistent pain |
Other relevant outcomes: 58.8% reported neck pain 54.0% reported back pain 53.6% reported shoulder pain Shorter surgeons and surgeons with smaller glove size were more likely to experience strain (P = 0.03) To decrease pain, surgeons changed positions (79%), limited their number of cases per day (14%), spread cases throughout the week (6%), or limited their total number of cases (3%) 29% had received treatment at any time for pain symptoms 16% of those with pain symptoms had received formal ergonomic training |
Franasiak et al32 |
Sample: robotic surgeons at the University of North Carolina (Ear Nose Throat, Urology, Obstetrics, and Gynecology) Response rate: 62.7% (42/67) |
Robotic |
Modified version of the Nordic Musculoskeletal Questionnaire |
Primary outcome: 45.2% (19/42) respondents reported strain specifically caused by robotic surgery (ever) Additional results from the NMQ (12-month prevalence) Neck: 74% (14/19) Shoulders: 53% (10/19) Lower back: 42% (8/19) Wrist/hands 37% (7/19) |
Other relevant outcomes: Of those surgeons reporting strain, 26% (5/19) had persistent strain related to robotic surgery Two surgeons had been prevented from performing normal daily activities from strain related to robotic surgery Three surgeons reported seeking professional medical care for strain attributed to robotic surgery Of those surgeons (P = 32) who received 5-minute in-person ergonomic training program regarding console set-up instructions, 88% changed their practice. After this training, 74% of surgeons who reported strain, noted decrease in strain |
Giberti et al33 |
Sample: 39 robotic surgeons from Italian robotic centers Response rate: 44% (17/39) |
Robotic |
Modified Standardized Nordic Musculoskeletal Questionnaire |
Primary outcome: 41% (7/17) reported recurrent musculoskeletal pain that started at the first use of the robot |
Other relevant outcomes: 35% (6/17) reported feeling pain during their daily surgical activities 29% (5/17) reported pain in the cervical spine 23.5% (4/17) reported pain in the upper limbs |
Gofrit et al46 |
Sample: Unknown Members of the Endourologic Society Response: 73 endourologists |
Laparoscopy, hand-assisted laparoscopic surgery (HALS) and robotic surgery |
Self-composed questionnaire |
Primary outcome: 30% (22/73) reported neuromuscular or arthritic symptoms during surgery |
Other relevant outcomes: 18% (13/73) reported paresthesias, most commonly in the thumb and/or middle finger HALS was most associated with symptoms, and robotic surgery was least associated with symptoms The total number of laparoscopic procedures performed by the responder was significantly positively correlated with the risk of sustaining an injury |
Hemal et al 56 |
Sample: 350 urologists Response rate: 58.3% (204/350) |
Laparoscopic and open surgery |
Self-composed questionnaire |
Primary outcome: prevalence of pain and stiffness in laparoscopic and open surgery, further subdivided into Frequent neck pain in laparoscopy and open surgery: 13% and 6%respectively. Frequent shoulder stiffness in laparoscopy and open surgery: 18% and 10%respectively. Frequent finger numbness in laparoscopic and open surgery: 18% and 2.8%respectively |
Other relevant outcomes: The frequency of finger numbness and eye strain was significantly higher in laparoscopic surgeons than open surgery (P = 0.004) |
Johnston et al57 |
Sample: 42 laparoscopic program directors Response rate: 60% (25/42) urologists |
Laparoscopy, hand-assisted laparoscopic surgery (HALS) |
Self-composed questionnaire |
Primary outcome: There were significantly more hand/wrist, forearm, and shoulder pain/injuries associated with HALS ( 0.004) Hand-assisted laparoscopy is associated with more frequent neuromuscular strain to the upper extremity than standard laparoscopy, but surgeons performing standard laparoscopy experience more neck pain or injury. |
Other relevant outcomes: 33% of HALS versus 8% of Laparoscopy led to hand/wrist pain ''usually/frequently' 25% of HALS versus 10% Laparoscopy led to forearm/shoulder pain ''usually/frequently' 85% of Hals versus 60% Laparoscopy surgeons experience rarely or never neck pain 65% of HALS versus 66% Laparoscopy surgeons experience rarely or never back pain |
Kaya et al40 |
Sample: 100 OR personnel, including anesthesiologists and surgery nurses Response rate: 82% (82/100) |
Laparoscopy |
Self-composed questionnaire |
Primary outcome: 72% had neck pain and 70% back pain during laparoscopic surgery |
Other relevant outcomes: 68% reported discomfort due to self-reported static body posture 44% reported tremors resulting from instrument manipulation 41% of surgeons and 47% of residents reported discomfort owing to continuous foot flexion during foot pedal manipulation |
Liang et al36 |
Sample: 300 urologic surgeons in China Response rate: 80.3% (241/300) |
Laparoscopy |
Self-composed questionnaire |
Primary outcome: prevalence of musculoskeletal symptoms/discomfort, further subdivided into neck (58%), back (53%), shoulder (34%), wrist (33%), hand (30%), and leg (22%) |
Other relevant outcomes: Surgeons who had performed <250 surgeries experienced more discomfort than those with 250 surgeries in their hands (P = 0.029) wrists (P = 0.022) and backs (P = 0.026) Most of the respondents (84 6%) were unaware of the ergonomic guidelines |
Matern and Koneczny47 |
Sample: 3621 surgeons working in Germany Response rate: 11.7% (425/3621) |
Laparoscopic and open surgery 51% performed equal numbers of open and MIS procedures, 43% predominantly open, and 6% mainly MIS |
Self-composed surgery questionnaire |
Primary outcome: evaluation of workplace conditions in the operating room and pain during surgery, with the latter further subdivided into Back: 85% Neck: 60% Upper arms: 39% |
Other relevant outcomes: The common working posture was considered to be uncomfortable or painful by 84% of surgeons About 1/of surgeons took pain relievers or underwent physiotherapy 43% of the participating surgeons admitted that their working posture had led to situations that were potentially hazardous for OR personnel and/or the patient 97% of the surgeons felt that ergonomic improvement in the operating room was necessary, in relation to all OR aspects 57% had no problems with instruments for open surgery versus 17% for minimally invasive surgery 24% complained about pressure areas caused by instruments versus 36% for MIS Neuropraxia was reported by 14% due to open surgery versus 26% due to MIS |
McDonald et al48 |
Sample: 1279 gynecologic oncologists (members of the SGO) Response rate: 27.4% (350/1279) |
Open, laparoscopic, and robotic surgery |
Self-composed questionnaire |
Primary outcome: 61% of respondents reported physical symptoms related to MIS |
Other relevant outcomes: The rate of symptoms was higher in the robotic group (72%) than the laparoscopic (57%) or abdominal group (49%) (P = 0.0052) Stiffness (P = 0.0373) and fatigue (P = 0.0125) were more common in the robotic group Female sex (0.0001) higher caseload (P = 0.0007) and academic practice (P = 0.0186) were associated with increased symptoms Multivariate analysis revealed that robotic surgery (odds ratio [OR] 2.38, 95% CI 1.20–4.69) and female sex (OR 4.20, 95% CI 2.13–8.29) were significant predictors of symptoms |
Miller et al25 |
Sample: Unknown Respondents: 61 laparoscopic surgeons in the central Texas area |
Laparoscopy |
Modified survey based on the SAGES Task Force on Ergonomics Questionnaire and the Safety Attitudes Questionnaire (SAQ) |
Primary outcome: 100% (61/61) of laparoscopic surgeons reported experiencing at least injury/illness symptom as result of performing laparoscopic surgery |
Other relevant outcomes: The average number of self-reported symptomatic areas was 8.4 Symptoms most reported as frequent included neck stiffness (26%), back stiffness (26%), and back pain (23%) Respondents who were able to assess their operating room conditions, were less likely to experience injury/illness symptoms than respondents who were undecided about their operating room conditions |
Morandeira-Rivas et al37 |
Sample: 262 surgeons Response rate: 29 8% (78/262) |
SILS |
Questionnaire elaborated by the ergonomics subcommittee of the SAGES |
Primary outcome: 81% (63/78) of surgeons reported 2 or more musculoskeletal symptoms during or after performing LESS surgery, further subdivided into Occasional or frequent pain: neck 54%, back 53%, shoulder/arm 51%, hand/wrist 49% Occasional or frequent stiffness: neck 42%, shoulder/arm 41%, back 41%, hand/wrist 38% |
Other relevant outcomes: 62% reported that LESS surgery caused more discomfort than conventional laparoscopic surgery |
Park et al19 |
Sample: 2000 members of SAGES Response rate: 15.9% (317/2000) |
Laparoscopy |
Self-composed questionnaire |
Primary outcome: 86.9% (272/317) reported physical symptoms or discomfort Other relevant outcomes: The strongest predictor of symptoms was high case volume—except for eye and back symptoms, which were consistently reported even with low case volumes |
Other injuries or conditions reported: carpal tunnel syndrome (P = 4) disc problems (P = 4) headache (P = 3) tennis elbow (P = 2) and shoulder muscle spasm (P = 2) Women reported more arm symptoms, and men reported more lower extremity problems |
Plerhoples et al16 |
Sample: 19, 868 surgeons worldwide from all specialties practicing all approaches Response rate: 6.1% (1215/19, 868) |
Open, laparoscopic, and robotic surgery |
Self-composed questionnaire |
Primary outcome: 69% (834/1215) reported physical discomfort or symptoms attributable to operating, further subdivided into Neck: 35.2% in robotic surgery, 44.1% in laparoscopic surgery, 46.6% in open surgery Upper back: 21.0% in robotic surgery, 41.4% in laparoscopic surgery, 39% in open surgery Right shoulder: 7.9% in robotic surgery, 33.2% in laparoscopic surgery, 12.3% in open surgery Left shoulder: 6.9% in robotic surgery, 27.7% in laparoscopic surgery, 10.2% in open surgery Lower back: 18.9% in robotic surgery, 44.5% in laparoscopic surgery, 51.8% in open surgery |
Other relevant outcomes: 70% reported pain while performing laparoscopic surgery, compared with 36% for robotic, and 65% for open surgery (0.0001) 30% of surgeons said they give at least some consideration to their own physical discomfort when choosing an operative modality Persistent or chronic pain: 5% in robotic surgery, 19% in laparoscopic surgery, and 17% in open surgery (0.0001) 99 of 214 surgeons (8%) reported an injury requiring treatment due to laparoscopic surgery, 76 (6%) due to open surgery, and 30 (3%) due to robotic surgery |
Quinn and Moohan49 |
Sample: 89 trainees in obstetrics and gynecology of the Northern Ireland Deanery. Response rate: 59.6% (53/89) |
Laparoscopy |
Self-composed questionnaire |
Primary outcome: 84.9% (45/53) of trainees reported pain during laparoscopic surgery, further subdivided into Neck: 42% Back: 72% Shoulder: 43% Leg: 37% |
Other relevant outcomes: Two trainees had required sick leave as result of pain, while trainee had sought medical attention Seventeen trainees had received treatment (analgesia, physiotherapy, or alternative) for their symptoms |
Ruitenburg et al 41 |
Sample: 458 surgeons and other hospital physicians Response rate: 41.2% (395/958) including 100 surgeons |
General surgery |
Self-composed questionnaire, Task Recording and Analysis on Computer (TRAC) observation system |
Primary outcome: 41% (37/91) of surgeons found their work physically strenuous versus 13% (35/280) of other physicians (0.000) |
Other relevant outcomes: Both groups reported that most of their physical complaints were in their neck (39 and 32%) and 17% vs 15% found this to be work-impairing) and arm regions (36 and 27% 42% vs 26%) found this work-impairing) Compared with hospital physicians, significantly more surgeons (56 vs 14%) respectively) indicated that their work contributed to physical complaints in the leg region. 14% of surgeons and 21% of other hospital physicians experienced difficulties at work because of impairments in their physical well-being |
Santos-Carreras et al17 |
Sample: 250 surgeons Response rate: 19.6% (49/250) |
Open, laparoscopic, and robotic surgery |
Self-composed questionnaire |
Primary outcome: main body areas of complaints during surgery, further subdivided into Back: 52% in open surgery, 35% in laparoscopic surgery, 20% in robotic surgery Neck: 52% in open surgery, 38% in laparoscopic surgery, 28% in robotic surgery |
Other relevant outcomes: Finger discomfort was experienced by 28% during laparoscopic surgery |
Sari et al20 |
Sample: 92 laparoscopic surgeons and surgical trainees (gynecologists, general surgeons, and urologists) Response rate: 60% (55/92) |
Laparoscopic surgery |
Self-composed questionnaire |
Primary outcomes: 73% (40 of 55) reported physical complaints during or after laparoscopic procedures |
Other relevant outcomes: The most frequently affected body areas were shoulders (45%), low back (26%), and neck (15%) Among surgeons with less experience (<50 procedures) 12 (86%) surgeons had physical complaints, whereas 28 (68%) surgeons in the more experienced group reported complaints (P = 0.011) |
Shepherd et al50 |
Sample: Unknown Respondents: 50 surgeons and trainees in Southeast England |
Laparoscopic surgery |
Self-composed questionnaire |
Primary outcome: symptoms were reported in at least body region by 76% during short cases and 81% during long cases. |
Other relevant outcomes: 41% of respondents reported moderate or severe discomfort due to the use of laparoscopic instruments Female sex and those with smaller glove size or fewer years of experience were more likely to report symptoms related to instrument handle dimensions 69% of respondents believed ergonomics should be incorporated into courses |
Stomberg et al51 |
Sample: 558 general surgeons and gynecologists Response rate: 68% (378/558) 204 performed both laparoscopy and laparotomy and were analyzed |
Laparoscopic surgery |
Self-composed questionnaire |
Primary outcome: More than 70% of the laparoscopists had or more physical symptoms/pain, further subdivided into Lower back: 55% of gynecologists versus 48% of general surgeons Neck: 50% of gynecologists versus 44% of general surgeons Shoulder: 52% of gynecologists versus 37% of general surgeons |
Other relevant outcomes: Pain was the most common symptom, followed by fatigue and stiffness Longer work experience and ageing were associated with significantly more disorders (0.01) Female physicians had significantly more symptoms in the neck, shoulders, wrists, upper-back, and head (0.01) |
Sutton et al52 |
Sample: 2000 members of the SAGES Response rate: 15.7% (314/2000) |
Laparoscopic surgery |
Self-composed questionnaire |
Primary outcome: 86.5% of women reporting attributed physical discomfort to laparoscopic surgery, which was comparable to men Operating, further subdivided into discomfort in lower body (hips, knees, ankles, and feet) 20% (11/54) of females versus 35% (91/261) of males discomfort of shoulder area (neck, shoulder, and upper back) 77% of females versus 27% of males discomfort in neck: 62% of females versus 18% of males |
Other relevant outcomes: Female surgeons were more likely to receive treatment for their hands, including the wrist, thumb, and fingers (odds ratio 3.5, P = 0.028) Women with larger glove size (7–8.5) reported more cases of treatment for their hands than men with the same glove size (21%) vs 3%, P = 0.016) Women who wore size 5.5–6.5 surgical glove reported significantly more cases of discomfort in their shoulder area (neck, shoulder, and upper back) than men who wore the same size surgical glove (77%) vs 27%, P = 0.004) |
Szeto et al34 |
Sample: 500 general surgeons working in general surgery departments in public hospitals in Hong Kong Response rate: 27% (135/500) |
Open, laparoscopic, endovascular, and endourology surgery |
Self-composed questionnaire including a modified Standardized Nordic Musculoskeletal Questionnaire and a modified workstyle short form |
Primary outcome: Over 80% of the respondents reported musculoskeletal symptoms in at least 1 area within the past 12 months, further subdivided into Neck: 82.9% Low back: 68.1% Shoulder: 57.8% Upper back: 52.6% |
Other relevant outcomes: 88.9% of respondents perceived sustained static and/or awkward posture as the factor most commonly associated with neck symptoms 35.6% of respondents reported "working through pain so that the quality of their work would not suffer" Medical treatment: 7% for neck pain, 8% for lower back pain, 7% for upper back pain, 2% for shoulder pain Medication use: 14% for neck pain, 2% for lower back pain, 6% for upper back pain, 5% for shoulder pain |
Tjiam et al53 |
Sample: unknown Respondents: 285 urologists from different countries (mainly Europe) performing endourology and laparoscopy |
Laparoscopy and endourology |
Self-composed questionnaire |
Primary outcome: 86.0% (245/285) experienced musculoskeletal complaints within the past 12 months, further subdivided into Neck: 59.3% (30.5% mild, 18.9% moderate, 8.8% serious, 1.1% severe) Back: 56.9% (22.8% mild, 23.5% moderate, 8.8% serious, 1.8% severe) Shoulder: 51.2% (22 1% mild, 18.9% moderate, 9.1% serious, 1.1% severe) Arm: 26% (13, 7% mild, 9, 8% moderate, 2, 5% serious, 0% severe) Wrist: 20.8% (11.6% mild, 6.7% moderate, 2.1% serious, 0.4% severe) Hand: 21.4% (14 0% mild, 4.6% moderate, 2.1% serious, 0.7% severe) |
Other relevant outcomes: 49% of the urologists experienced chronic musculoskeletal complaints, with significant risk factors including endourology (OR 3.06; 95% confidence interval 1.37–6.80) and laparoscopy (OR 1.70; 95% CI 1.27–2.28) |
Trejo et al38 |
Sample: unknown Laparoscopic surgery Respondents: 38 laparoscopic surgeons from all over the US (all attendants of the advanced laparoscopic training courses at the University of Nebraska Medical Center) |
Laparoscopic surgery |
Self-composed questionnaire |
Primary outcome: 66% (25/38) experienced problems using the conventional grasper, with 29% of surgeons reporting numbness of the fingers or thumb after surgery with conventional laparoscopic tools |
Other relevant outcomes: Pain (stiffness) in other body areas, further subdivided into Neck: 65% (62%) Shoulder/arm: 48% (58%) Hand/wrist: 55% (48%) Back: 50% (52%) |
Van Veelen et al13 |
Sample: 80 Including surgeons, residents, anesthesiologists, anesthesiologist assistants, surgical nurses Response rate: 79% (63/80) |
Laparoscopy, arthroscopy, and angioscopy |
Observation, self-composed questionnaire |
Primary outcome: 63% (40/63) experienced physical discomfort during the surgical procedure |
Other relevant outcomes: The surgeons and residents reported that manipulating endoscopic products caused discomfort in the head, shoulders, neck, arms, back, and hands The main causes were the positioning of apparatus and staff, work clothing, and the limited reach of apparatus and/or instruments The lead apron caused discomfort in the neck, shoulders, and back (surgeons/residents 42% anesthesiologists/assistants 36% surgical nurses 49% |
Wauben et al14 |
Sample: 1292 surgeons and residents, working mainly in Europe, performing laparoscopic and/or thoracoscopic procedures within the digestive, thoracic, urologic, gynecologic, and paediatric disciplines Response rate: 22% (284/1292) |
Laparoscopy and thoracoscopy |
Self-composed questionnaire |
Primary outcome: Physical discomfort during laparoscopy, further subdivided into Neck pain: 78% Shoulder pain: 77% Back pain: 77% |
Other relevant outcomes: 88% experienced muscle fatigue due to static posture 64% agreed with the proposition that bad table height causes discomfort in the neck 77% agreed with the proposition that bad table height causes discomfort in the shoulders 70% agreed with the proposition that monitor height causes discomfort in the neck 76% agreed with the proposition that monitor position causes discomfort in the neck 57% agreed with the proposition that foot pedals cause discomfort in the foot 89% were unaware of ergonomic guidelines, although 100% stated that they find ergonomics important |
Wolf Jr et al58 |
Sample: unknown (18 academic centers in the United States) Respondents: 18 urologists (from 15 different centers) |
Laparoscopy |
Self-composed questionnaire |
Primary outcome: 28% and 17% reported frequent neck and shoulder pain, respectively, in association with laparoscopy |
Other relevant outcomes: Occasional pain was experienced by 67% in the wrists, 33% in the back, and 11% in the elbow To alleviate strain, 61% lowered the table, and 39% altered the manner in which instruments are held. Two surgeons obtained professional consultation for their injuries |
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