International Urogynecology Journal

, Volume 30, Issue 2, pp 231–237 | Cite as

Sitting versus standing makes a difference in musculoskeletal discomfort and postural load for surgeons performing vaginal surgery

  • Ruchira SinghEmail author
  • Ladin A. Yurteri-Kaplan
  • Melissa M. Morrow
  • Amy L. Weaver
  • Michaela E. McGree
  • Xinhui Zhu
  • Victor L. Paquet
  • John B. Gebhart
  • Susan Hallbeck
Original Article


Introduction and hypothesis

We compared musculoskeletal discomfort and postural load among surgeons in sitting and standing positions during vaginal surgery.

Materials and methods

Assessment of discomfort and posture of the primary surgeons in both positions was performed at two institutions. The primary outcome was an increase in body discomfort score after surgery as determined from subjective responses using validated tools. The secondary outcome was the percentage of time spent in awkward body postures measured objectively and stratified into awkward postures for neck, trunk, and bilateral shoulder angles. Variables were compared between sitting and standing positions using Fisher’s exact test for primary outcomes and Wilcoxon rank-sum test for secondary outcomes.


Data were collected for 24 surgeries from four surgeons in sitting position and nine surgeries from nine surgeons in standing position. The standing surgeons reported a significant increase in discomfort postoperatively for bilateral wrists, thighs, and lower legs compared with the sitting surgeons. The median percentage of time spent in awkward postures was significantly lower for the trunk in the standing versus sitting position (median 0.3% vs 58.8%, p < 0.001) but was significantly higher for both shoulders in the standing versus the sitting position (right shoulder: median 17.8% vs 0.3%, p = 0.003; left shoulder: median 7.4% vs 0.2%, p = 0.003).


Surgeons reported more discomfort in when performing vaginal surgery while standing. The postural load was worse for trunk but favorable for bilateral shoulders when seated. Such differences may impact a surgeon’s decision to perform vaginal surgery seated rather than standing.


Ergonomics Vaginal surgery Musculoskeletal discomfort Postural load 


Compliance with ethical standards

Conflicts of interest

Ruchira Singh: None.

Ladin A. Yurteri-Kaplan: None.

Melissa M. Morrow: None.

Michaela E. McGree: None.

Amy L. Weaver: None.

Xinhui Zhu: None.

Victor L. Paquet: None.

John B. Gebhart: Royalties - UpToDate and Elsevier.

Susan Hallbeck: None.

Paper presentation

Accepted for oral poster presentation at the 43rd Annual Scientific Meeting of the Society of Gynecologic Surgeons, 26–29 March 2017, San Antonio, TX, USA.




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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  • Ruchira Singh
    • 1
    Email author
  • Ladin A. Yurteri-Kaplan
    • 2
  • Melissa M. Morrow
    • 3
    • 4
  • Amy L. Weaver
    • 3
  • Michaela E. McGree
    • 3
  • Xinhui Zhu
    • 5
  • Victor L. Paquet
    • 6
  • John B. Gebhart
    • 7
  • Susan Hallbeck
    • 3
    • 4
  1. 1.Department of Obstetrics and GynecologyUniversity of FloridaJacksonvilleUSA
  2. 2.Department of Obstetrics and GynecologyColumbia University New York PresbyterianNew YorkUSA
  3. 3.Department of Health Sciences ResearchMayo ClinicRochesterUSA
  4. 4.Robert D. and Patricia E. Kern Center for the Science of Health Care DeliveryMayo ClinicRochesterUSA
  5. 5.School of Mechanical, Industrial, and Manufacturing EngineeringOregon State UniversityCorvallisUSA
  6. 6.Department of Industrial and Systems EngineeringUniversity at Buffalo, The State University of New YorkBuffaloUSA
  7. 7.Department of Obstetrics and GynecologyMayo ClinicRochesterUSA

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