66. Surgical Ergonomics with Dr. Andrew Gabrielson

Operate with Zen

Andrew Gabrielson, MD (@urogabe) is currently a resident at the Brady Urological Institute and Department of Urology at Johns Hopkins. He is a budding pediatric urologist and developed an interest in surgical ergonomics and physical well-being before he started residency. He is an integral member of the Society of Surgical Ergonomics and well-published in the field despite his young age! He gives us lots of practical knowledge for the operating room (how to stand, how to set up your room, gel pads and shoes!) and a framework for incorporating ergonomics as a thought process to enhance our physical well-being as surgeons. In addition, he talks about his experience and how following an interest piqued during undergraduate and medical school turned into a passion for the remainder of his professional life! Enjoy! Lots of links below including data supporting a lot of the discussion.

Society of Surgical Ergonomics

https://www.societyofsurgicalergonomics.org/

Twitter: @SocSurgErgo

Epidemiology of work-related pain among surgeons

Epstein, S. et al. Prevalence of work- related musculoskeletal disorders among surgeons and interventionalists: a systematic review and meta-analysis. JAMA Surg. 153, e174947–e174947 (2018).

Stucky, C. H. et al. Surgeon symptoms, strain, and selections: systematic review and meta- analysis of surgical ergonomics. Ann. Med. Surg. 27, 1–8 (2018)

Intraoperative and perioperative stretching

Park, A. E. et al. Intraoperative “Micro Breaks” with targeted stretching enhance surgeon physical function and mental focus: a multicenter cohort study. Ann. Surg. 265, 340–346 (2017).

Hallbeck, M. S. et al. The impact of intraoperative microbreaks with exercises on surgeons: a multicenter cohort study. Appl. Ergon. 60, 334–341 (2017).

Dorion, D. & Darveau, S. Do micropauses prevent surgeon’s fatigue and loss of accuracy associated with prolonged surgery? An experimental prospective study. Ann. Surg. 257, 256–259 (2013).

Monitor Placement

van Det, M. J., Meijerink, W. J., Hoff, C., Totte, E. R. & Pierie, J. P. Optimal ergonomics for laparoscopic surgery in minimally invasive surgery suites: a review and guidelines. Surg. Endosc. 23, 1279–1285 (2009).

Omar, A. M., Wade, N. J., Brown, S. I. & Cuschieri, A. Assessing the benefits of “gaze- down” display location in complex tasks. Surg. Endosc. 19, 105–108 (2005).

Erfanian, K., Luks, F. I., Kurkchubasche, A. G., Wesselhoeft, C. W. Jr. & Tracy, T. F. Jr. In- line image projection accelerates task performance in laparoscopic appendectomy. J. Pediatr. Surg. 38, 1059–1062 (2003).

Hanna, G. B., Shimi, S. M. & Cuschieri, A. Task performance in endoscopic surgery is influenced by location of the image display. Ann. Surg. 227, 481–484 (1998).

Table Height

Berguer, R., Smith, W. D. & Davis, S. An ergonomic study of the optimum operating table height for laparoscopic surgery. Surg. Endosc. 16, 416–421 (2002).

van Veelen, M. A., Kazemier, G., Koopman, J., Goossens, R. H. & Meijer, D. W. Assessment of the ergonomically optimal operating surface height for laparoscopic surgery. J. Laparoendosc. Adv. Surg. Tech. A. 12, 47–52 (2002).

Manasnayakorn, S., Cuschieri, A. & Hanna, G. B. Ergonomic assessment of optimum operating table height for hand- assisted laparoscopic surgery. Surg. Endosc. 23, 783–789 (2009).

Gel mats

Haramis, G. et al. Prospective randomized evaluation of FOOT gel pads for operating room staff COMFORT during laparoscopic renal surgery. Urology 76, 1405–1408 (2010).

Graversen, J. A. et al. Prospective randomized evaluation of gel mat foot pads in the endoscopic suite. J. Endourol. 25, 1793–1796 (2011).

Cognitive Ergonomics

Chrouser KL