Background
Musculoskeletal disorders (MSDs) are an occupational hazard amongst surgeons, causing detrimental effects in up to 20% of surgeons in their lifetime. However, there is a paucity of data examining solutions for the problem. There is also a lack of research comparing MSDs in surgeons who perform open surgery compared with those who perform newer methods of surgery such as laparoscopic and robotic surgery.
Aims
We aim to explore existing literature about the various risk factors and the consequences of MSDs. We believe that by raising awareness of such risk factors to medical students from early on in their medical careers, they can develop an appreciation of the potential long-term impacts and take an early approach to prevention. We discuss preventative strategies in the categories of individual, occupational, institutional, and intra-operative techniques.
Materials and Methods
Ovid Medline, Cochrane Library, and PubMed databases were used to identify articles. Studies reporting on work-related MSDs in surgeons were included. Articles relevant to medical fields with a high level of surgical involvement, such as gynaecology, were also included. This information was used to construct a narrative review of the literature (see Appendix 1 for full methodology). Within each database search, only a few articles relevant to this review were generated. Therefore, the citations were also screened to find additional articles that fit within the scope of this review.
Results
Multiple factors were found to contribute to the development of MSDs, including individual and occupational factors. MSDs have resulted in a high percentage of surgeons performing fewer surgeries or taking more time off work. Similar risk factors applied to laparoscopic and robotic surgery. Few studies examined strategies to combat MSDs, but techniques such as intraoperative exercise and ergonomic training have shown to be promising.
Conclusion
There is a need for ongoing research into strategies to prevent MSDs in surgeons. Currently there are no evidence-based guidelines for management of work-related MSDs. Medical students should be aware that this occupational hazard has deleterious effects on the body and should be encouraged to employ some of the currently available strategies to prevent MSDs. The authors of this review advocate for ergonomics education to be integrated into surgical training programs via collaboration between ergonomists and surgical program directors.
Main Learning Points
- MSDs in surgeons are under-researched but are still an important occupational hazard that can be potentially debilitating.
- There are no guidelines to manage MSDs – current best strategies involve having a well-balanced lifestyle, seeking help early, and being ergonomically aware of mechanisms of injury.
- Greater awareness of ergonomics among surgeons could possibly reduce the incidence of MSDs among high risk groups.