Musculoskeletal System Problems Seen in Surgeons

Yıl 2023, Cilt: 7 Sayı: 3, 169 - 177, 08.12.2023

Deniz Demirci , Berna Karamancıoğlu , Beyzanur Dikmen Hoşbaş , Eda Gökçe Özülkülü

Öz

The long working hours of physicians and especially the uncomfortable postures that surgeons are exposed to due to their jobs cause various pains. Although musculoskeletal pain affects daily and career life, it also poses a risk factor for occupational injuries. It is thought that surgeons' sense of neck proprioception may be affected, pain levels may increase, and their surgical careers may be adversely affected due to non-ergonomic operating room conditions, long-term staying in fixed positions and failure to maintain proper body posture. Surgeons should be promoted to participate in appropriate injury prevention exercise programs and postural training, starting with improving ergonomic conditions in operating theatres to prevent musculoskeletal problems or reduce existing pain.

Anahtar Kelimeler

Neck pain, Neck posture, Surgeons

CERRAHLARDA GÖRÜLEN KAS İSKELET SİSTEMİ PROBLEMLERİ

Öz

Hekimlerin uzun çalışma saatleri ve özellikle cerrahların işleri gereği maruz kaldığı konforsuz duruşlar çeşitli ağrılara sebep olmaktadır. Kas-iskelet ağrısı günlük yaşamı, kariyer ömrünü etkilemekle birlikte, mesleki yaralanmalar için risk faktörü oluşturmaktadır. Ergonomik olmayan ameliyathane şartları, uzun süreli sabit pozisyonlarda kalmak ve düzgün vücut postürünün korunamaması gibi sebeplerle cerrahların boyun propriosepsiyon duyusunun da etkilenebileceği, ağrı düzeylerinde artış gözlenebileceği ve cerrahi kariyerlerinin olumsuz etkilenebileceği düşünülmektedir. Cerrahların kas-iskelet problemlerini önlemek veya var olan ağrıyı azaltmak için ameliyathanelerdeki ergonomik koşulların iyileştirilmesinden başlanarak, uygun yaralanma önleyici egzersiz programları ve postüral eğitimlere katılımları teşvik edilmelidir.

Anahtar Kelimeler

Cerrahlar, Mesleki hastalıklar, Kas iskelet sistemi

Kaynakça

• Aaron, K.A., Vaughan, J., Gupta, R., Ali, N.-E.-S., Beth, A.H., Moore, J. M., Ma, Y., Ahmad, I., Jackler, R.K. & Vaisbuch, Y. (2021). The risk of ergonomic injury across surgical specialties. PLoS One, 16(2), e0244868.
• Adams, S.R., Hacker, M.R., McKinney, J. L., Elkadry, E.A. & Rosenblatt, P.L. (2013). Musculoskeletal pain in gynecologic surgeons. Journal of minimally invasive gynecology, 20(5), 656-660.
• Alhusuny, A., Cook, M., Khalil, A., Xie, Y. & Johnston, V. (2020). Neck/shoulder problems and visual disturbances among surgeons: a scoping review. Journal of Surgical Research, 247, 413-428.
• Alleblas, C.C., Formanoy, M.A., Könemann, R., Radder, C.M., Huirne, J.A. & Nieboer, T.E. (2016). Ergonomics in gynecologists’ daily practice: a nationwide survey in The Netherlands. Work, 55(4), 841-848.
• Cass, G., Vyas, S. & Akande, V. (2014). Prolonged laparoscopic surgery is associated with an increased risk of vertebral disc prolapse. Journal of Obstetrics and Gynaecology, 34(1), 74-78.
• Cavanagh, J., Brake, M., Kearns, D. & Hong, P. (2012). Work environment discomfort and injury: an ergonomic survey study of the American Society of Pediatric Otolaryngology members. American Journal of Otolaryngology, 33(4), 441-446.
• Christensen, J.R., Faber, A., Ekner, D., Overgaard, K., Holtermann, A. & Søgaard, K. (2011). Diet, physical exercise and cognitive behavioral training as a combined workplace based intervention to reduce body weight and increase physical capacity in health care workers-a randomized controlled trial. BMC Public Health, 11, 1-11.
• Côté, J.N. (2012). A critical review on physical factors and functional characteristics that may explain a sex/gender difference in work-related neck/shoulder disorders. Ergonomics, 55(2), 173-182.
• Dalager, T., Søgaard, K., Boyle, E., Jensen, P.T. & Mogensen, O. (2019). Surgery is physically demanding and associated with multisite musculoskeletal pain: a cross-sectional study. Journal of Surgical Research, 240, 30-39.
• Davis, W.T., Fletcher, S.A., & Guillamondegui, O D. (2014). Musculoskeletal occupational injury among surgeons: effects for patients, providers, and institutions. Journal of Surgical Research, 189(2), 207-212.
• Forst, L., Friedman, L. & Shapiro, D. (2006). Carpal tunnel syndrome in spine surgeons: a pilot study. Archives of Environmental and Occupational Health, 61(6), 259-262.
• Franasiak, J., Ko, E.M., Kidd, J., Secord, A.A., Bell, M., Boggess, J.F. & Gehrig, P.A. (2012). Physical strain and urgent need for ergonomic training among gynecologic oncologists who perform minimally invasive surgery. Gynecologic oncology, 126(3), 437-442.
• Hallbeck, M., Lowndes, B.R., Bingener, J., Abdelrahman, A., Yu, D., Bartley, A. & Park, A. (2017). The impact of intraoperative microbreaks with exercises on surgeons: a multi-center cohort study. Applied Ergonomics, 60, 334-341.
• Hemal, A., Srinivas, M., & Charles, A. (2001). Ergonomic problems associated with laparoscopy. Journal of Endourology, 15(5), 499-503.
• Howarth, A.L., Hallbeck, S., Mahabir, R.C., Lemaine, V., Evans, G. R. & Noland, S.S. (2019). Work-related musculoskeletal discomfort and injury in microsurgeons. Journal of Reconstructive Microsurgery, 35(05), 322-328.
• Hubert, N., Gilles, M., Desbrosses, K., Meyer, J., Felblinger, J. & Hubert, J. (2013). Ergonomic assessment of the surgeon's physical workload during standard and robotic assisted laparoscopic procedures. The International Journal of Medical Robotics and Computer Assisted Surgery, 9(2), 142-147.
• Huysmans, M.A., Hoozemans, M.J., van der Beek, A.J., de Looze, M.P. & van Dieën, J.H. (2010). Position sense acuity of the upper extremity and tracking performance in subjects with non-specific neck and upper extremity pain and healthy controls. Journal of Rehabilitation Medicine, 42(9), 876-883.
• Jay, K., Jakobsen, M.D., Sundstrup, E., Skotte, J. H., Jørgensen, M.B., Andersen, C.H., Pedersen, M. T. & Andersen, L. L. (2013). Effects of kettlebell training on postural coordination and jump performance: a randomized controlled trial. The Journal of Strength & Conditioning Research, 27(5), 1202-1209.
• Karatas, N., Bicici, S., Baltaci, G. & Caner, H. (2012). The effect of Kinesiotape application on functional performance in surgeons who have musculo-skeletal pain after performing surgery. Turkish Neurosurgery, 22(1), 83-89.
• Kristjansson, E. & Treleaven, J. (2009). Sensorimotor function and dizziness in neck pain: implications for assessment and management. Journal of Orthopaedic & Sports Physical Therapy, 39(5), 364-377.
• Lee, G., Lee, M., Green, I., Allaf, M. & Marohn, M. (2017). Surgeons’ physical discomfort and symptoms during robotic surgery: a comprehensive ergonomic survey study. Surgical Endoscopy, 31, 1697-1706.
• Matern, U. (2009). Ergonomic deficiencies in the operating room: examples from minimally invasive surgery. Work, 33(2), 165-168.
• Mavrovounis, G., Meling, T.R., Lafuente, J., Fountas, K.N. & Demetriades, A.K. (2021). Postural ergonomics and work-related musculoskeletal disorders in neurosurgery: lessons from an international survey. Acta Neurochirurgica, 163, 1541-1552.
• Miranda, H., Kaila-Kangas, L., Heliövaara, M., Leino-Arjas, P., Haukka, E., Liira, J. & Viikari-Juntura, E. (2010). Musculoskeletal pain at multiple sites and its effects on work ability in a general working population. Occupational and Environmental Medicine, 67(7), 449-455.
• Mourcou, Q., Fleury, A., Diot, B., Franco, C. & Vuillerme, N. (2015). Mobile phone-based joint angle measurement for functional assessment and rehabilitation of proprioception. BioMed Research International, 2015, e328142.
• 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), 306-313.
• Phongamwong, C. & Deema, H. (2015). The impact of multi-site musculoskeletal pain on work ability among health care providers. Journal of Occupational Medicine and Toxicology, 10, 1-5.
• Pillastrini, P., de Lima e Sá Resende, F., Banchelli, F., Burioli, A., Di Ciaccio, E., Guccione, A., Villafañe, J.H. & Vanti, C. (2016). Effectiveness of global postural re-education in patients with chronic nonspecific neck pain: randomized controlled trial. Physical Therapy, 96(9), 1408-1416.
• Plerhoples, T.A., Hernandez-Boussard, T. & Wren, S.M. (2012). The aching surgeon: a survey of physical discomfort and symptoms following open, laparoscopic, and robotic surgery. Journal of Robotic Surgery, 6, 65-72.
• Quinn, D. & Moohan, J. (2015). The trainees’ pain with laparoscopic surgery: what do trainees really know about theatre set-up and how this impacts their health. Gynecological Surgery, 12(1), 71-76.
• Sari, V., Nieboer, T.E., Vierhout, M.E., Stegeman, D. F. & Kluivers, K.B. (2010). The operation room as a hostile environment for surgeons: physical complaints during and after laparoscopy. Minimally Invasive Therapy and Allied Technologies, 19(2), 105-109.
• Stomberg, M. W., Tronstad, S.-E., Hedberg, K., Bengtsson, J., Jonsson, P., Johansen, L. & Lindvall, B. (2010). Work-related musculoskeletal disorders when performing laparoscopic surgery. Surgical Laparoscopy Endoscopy and Percutaneous Techniques, 20(1), 49-53.
• Stucky, C.-C.H., Cromwell, K.D., Voss, R.K., Chiang, Y.-J., Woodman, K., Lee, J.E. & Cormier, J. N. (2018). Surgeon symptoms, strain, and selections: Systematic review and meta-analysis of surgical ergonomics. Annals of Medicine and Surgery, 27, 1-8.
• Szeto, G.P., Ho, P., Ting, A.C., Poon, J.T., Cheng, S.W. & Tsang, R.C. (2009). Work-related musculoskeletal symptoms in surgeons. Journal of Occupational Rehabilitation, 19, 175-184.
• Tan, K., & Kwek, E. (2020). Musculoskeletal occupational injuries in orthopaedic surgeons and residents. Malaysian Orthopaedic Journal, 14(1), 24-27.
• Vaisbuch,Y., Aaron, K.A., Moore, J.M., Vaughan, J., Ma, Y., Gupta, R., & Jackler, R.K. (2019). Ergonomic hazards in otolaryngology. The Laryngoscope, 129(2), 370-376.
• Vijendren, A., Yung, M., Sanchez, J. & Duffield, K. (2016). Occupational musculoskeletal pain amongst ENT surgeons–are we looking at the tip of an iceberg? The Journal of Laryngology & Otology, 130(5), 490-496.
• Voss, R.K., Chiang, Y.-J., Cromwell, K.D., Urbauer, D.L., Lee, J.E., Cormier, J.N. & Stucky, C.-C.H. (2017). Do no harm, except to ourselves? A survey of symptoms and injuries in oncologic surgeons and pilot study of an intraoperative ergonomic intervention. Journal of the American College of Surgeons, 224(1), 16-25. e11.
• Winters, J.N., Sommer, N.Z., Romanelli, M.R., Marschik, C., Hulcher, L. & Cutler, B.J. (2020). Stretching and strength training to improve postural ergonomics and endurance in the operating room. Plastic and Reconstructive Surgery Global Open, 8(5), e2810.
• Wolf, J.S., Marcovich, R., Gill, I.S., Sung, G.T., Kavoussi, L.R., Clayman, R.V., McDougall, E.M., Shalhav, A., Dunn, M.D. & Afane, J.S. (2000). Survey of neuromuscular injuries to the patient and surgeon during urologic laparoscopic surgery. Urology, 55(6), 831-836.
• Yoon, S.-H., Jung, M.-C. & Park, S.Y. (2016). Evaluation of surgeon’s muscle fatigue during thoracoscopic pulmonary lobectomy using interoperative surface electromyography. Journal of Thoracic Disease, 8(6), 1162.