Skip to main content
SpringerLink
Log in
Book cover

Surgeons as Educators pp 387–417Cite as

Surgical Ergonomics

  • Chapter
  • First Online:

Abstract

Musculoskeletal discomfort is common among surgeons. Surveys show that 77–100% of laparoscopic surgeons experience physical symptoms or discomfort attributed to operating, but few seek treatment. Surgeons are exposed to many risk factors for musculoskeletal discomfort and occupational injury, and surgical residents may be at additional risk given their inexperience. Surgeon discomfort has potential negative consequences on surgeon performance and patient outcomes, resulting in lost revenue and surgeon burnout. Improving surgical ergonomics can reduce discomfort and mitigate negative downstream consequences. In the operating room, this includes awareness of body posture and proper operating room setup. Other strategies include a warm-up prior to the first case and taking scheduled breaks during surgery. Outside of the operating room, surgeons can reduce discomfort by improving the ergonomics of their office environment and maintaining good health through routine exercise and stretching. Surgeon educators should teach residents ergonomic principles as well as model their implementation in the operating room.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Definition and Domains of Ergonomics. In: What is ergonomics? International Ergonomics Association. 2017. http://www.iea.cc/whats/. Accessed 4/11/2017.

  2. Bureau of Labor Statistics. In: Occupational employment statistics. U.S Department of Labor. 2015. www.bls.gov/oes/. Accessed 4 Nov 2017.

  3. Goodman GR. Electrosurgery burns and the urologist. J Urol. 1976;116(2):218–20.

    Article  CAS  PubMed  Google Scholar 

  4. Neuberger J, Vergani D, Mieli-Vergani G, Davis M, Williams R. Hepatic damage after exposure to halothane in medical personnel. Br J Anaesth. 1981;53(11):1173–7.

    Article  CAS  PubMed  Google Scholar 

  5. Berguer R, Forkey DL, Smith WD. Ergonomic problems associated with laparoscopic surgery. Surg Endosc. 1999;13(5):466–8.

    Article  CAS  PubMed  Google Scholar 

  6. Buia A, Stockhausen F, Hanisch E. Laparoscopic surgery: a qualified systematic review. World J Methodol. 2015;5(4):238–54. https://doi.org/10.5662/wjm.v5.i4.238.

    PubMed  PubMed Central  Google Scholar 

  7. Sari V, Nieboer TE, Vierhout ME, Stegeman DF, Kluivers KB. The operation room as a hostile environment for surgeons: physical complaints during and after laparoscopy. Minim Invasive Ther Allied Technol. 2010;19(2):105–9. https://doi.org/10.3109/13645701003643972.

    Article  PubMed  Google Scholar 

  8. Plerhoples TA, Hernandez-Boussard T, Wren SM. The aching surgeon: a survey of physical discomfort and symptoms following open, laparoscopic, and robotic surgery. J Robot Surg. 2012;6(1):65–72. https://doi.org/10.1007/s11701-011-0330-3.

    Article  PubMed  Google Scholar 

  9. Franasiak J, Ko EM, Kidd J, Secord AA, Bell M, Boggess JF, et al. Physical strain and urgent need for ergonomic training among gynecologic oncologists who perform minimally invasive surgery. Gynecol Oncol. 2012;126(3):437–42. https://doi.org/10.1016/j.ygyno.2012.05.016.

    Article  PubMed  Google Scholar 

  10. Miller K, Benden M, Pickens A, Shipp E, Zheng Q. Ergonomics principles associated with laparoscopic surgeon injury/illness. Hum Factors. 2012;54(6):1087–92. https://doi.org/10.1177/0018720812451046.

    Article  PubMed  Google Scholar 

  11. Park A, Lee G, Seagull FJ, Meenaghan N, Dexter D. Patients benefit while surgeons suffer: an impending epidemic. J Am Coll Surg. 2010;210(3):306–13. https://doi.org/10.1016/j.jamcollsurg.2009.10.017.

    Article  PubMed  Google Scholar 

  12. Stomberg MW, Tronstad SE, Hedberg K, Bengtsson J, Jonsson P, Johansen L, et al. Work-related musculoskeletal disorders when performing laparoscopic surgery. Surg Laparosc Endosc Percutan Tech. 2010;20(1):49–53. https://doi.org/10.1097/SLE.0b013e3181cded54.

    Article  PubMed  Google Scholar 

  13. Szeto GP, Ho P, Ting AC, Poon JT, Cheng SW, Tsang RC. Work-related musculoskeletal symptoms in surgeons. J Occup Rehabil. 2009;19(2):175–84. https://doi.org/10.1007/s10926-009-9176-1.

    Article  PubMed  Google Scholar 

  14. Wauben LS, van Veelen MA, Gossot D, Goossens RH. Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons. Surg Endosc. 2006;20(8):1268–74. https://doi.org/10.1007/s00464-005-0647-y.

    Article  CAS  PubMed  Google Scholar 

  15. Welcker K, Kesieme EB, Internullo E, Kranenburg van Koppen LJ. Ergonomics in thoracoscopic surgery: results of a survey among thoracic surgeons. Interact Cardiovasc Thorac Surg. 2012;15(2):197–200. https://doi.org/10.1093/icvts/ivs173.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hemal AK, Srinivas M, Charles AR. Ergonomic problems associated with laparoscopy. J Endourol. 2001;15(5):499–503. https://doi.org/10.1089/089277901750299294.

    Article  CAS  PubMed  Google Scholar 

  17. Bagrodia A, Raman JD. Ergonomics considerations of radical prostatectomy: physician perspective of open, laparoscopic, and robot-assisted techniques. J Endourol. 2009;23(4):627–33. https://doi.org/10.1089/end.2008.0556.

    Article  PubMed  Google Scholar 

  18. Quinn D, Moohan J. The trainees’ pain with laparoscopic surgery: what do trainees really know about theatre set-up and how this impacts their health. Gynecol Surg. 2015;12(1):71–6.

    Article  Google Scholar 

  19. Giberti C, Gallo F, Francini L, Signori A, Testa M. Musculoskeletal disorders among robotic surgeons: a questionnaire analysis. Arch Ital Urol Androl. 2014;86(2):95–8. https://doi.org/10.4081/aiua.2014.2.95.

    Article  PubMed  Google Scholar 

  20. Franasiak J, Craven R, Mosaly P, Gehrig PA. Feasibility and acceptance of a robotic surgery ergonomic training program. JSLS. 2014;18(4). https://doi.org/10.4293/JSLS.2014.00166.

  21. Soueid A, Oudit D, Thiagarajah S, Laitung G. The pain of surgery: pain experienced by surgeons while operating. Int J Surg. 2010;8(2):118–20. https://doi.org/10.1016/j.ijsu.2009.11.008.

    Article  CAS  PubMed  Google Scholar 

  22. Lawther RE, Kirk GR, Regan MC. Laparoscopic procedures are associated with a significant risk of digital nerve injury for general surgeons. Ann R Coll Surg Engl. 2002;84(6):443.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Liberman AS, Shrier I, Gordon PH. Injuries sustained by colorectal surgeons performing colonoscopy. Surg Endosc. 2005;19(12):1606–9. https://doi.org/10.1007/s00464-005-0219-1.

    Article  CAS  PubMed  Google Scholar 

  24. Singh R, Carranza Leon DA, Morrow MM, Vos-Draper TL, Mc Gree ME, Weaver AL, et al. Effect of chair types on work-related musculoskeletal discomfort during vaginal surgery. Am J Obstet Gynecol. 2016;215(5):648 e1–9. https://doi.org/10.1016/j.ajog.2016.06.016.

    Article  Google Scholar 

  25. Cass GK, Vyas S, Akande V. Prolonged laparoscopic surgery is associated with an increased risk of vertebral disc prolapse. J Obstet Gynaecol. 2014;34(1):74–8. https://doi.org/10.3109/01443615.2013.831048.

    Article  CAS  PubMed  Google Scholar 

  26. Adams SR, Hacker MR, McKinney JL, Elkadry EA, Rosenblatt PL. Musculoskeletal pain in gynecologic surgeons. J Minim Invasive Gynecol. 2013;20(5):656–60. https://doi.org/10.1016/j.jmig.2013.04.013.

    Article  PubMed  Google Scholar 

  27. McDonald ME, Ramirez PT, Munsell MF, Greer M, Burke WM, Naumann WT, et al. Physician pain and discomfort during minimally invasive gynecologic cancer surgery. Gynecol Oncol. 2014;134(2):243–7. https://doi.org/10.1016/j.ygyno.2014.05.019.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Auerbach JD, Weidner ZD, Milby AH, Diab M, Lonner BS. Musculoskeletal disorders among spine surgeons: results of a survey of the Scoliosis Research Society membership. Spine (Phila Pa 1976). 2011;36(26):E1715–21. https://doi.org/10.1097/BRS.0b013e31821cd140.

    Article  Google Scholar 

  29. Sivak-Callcott JA, Diaz SR, Ducatman AM, Rosen CL, Nimbarte AD, Sedgeman JA. A survey study of occupational pain and injury in ophthalmic plastic surgeons. Ophthal Plast Reconstr Surg. 2011;27(1):28–32. https://doi.org/10.1097/IOP.0b013e3181e99cc8.

    Article  PubMed  Google Scholar 

  30. Dhimitri KC, McGwin G Jr, McNeal SF, Lee P, Morse PA, Patterson M, et al. Symptoms of musculoskeletal disorders in ophthalmologists. Am J Ophthalmol. 2005;139(1):179–81. https://doi.org/10.1016/j.ajo.2004.06.091.

    Article  PubMed  Google Scholar 

  31. Kazancioglu HO, Bereket MC, Ezirganli S, Ozsevik S, Sener I. Musculoskeletal complaints among oral and maxillofacial surgeons and dentists: a questionnaire study. Acta Odontol Scand. 2013;71(3–4):469–74. https://doi.org/10.3109/00016357.2012.696688.

    Article  PubMed  Google Scholar 

  32. Shaik AR, Rao SB, Husain A, D'sa J. Work-related musculoskeletal disorders among dental surgeons: a pilot study. Contemp Clin Dent. 2011;2(4):308–12. https://doi.org/10.4103/0976-237X.91794.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Mirbod SM, Yoshida H, Miyamoto K, Miyashita K, Inaba R, Iwata H. Subjective complaints in orthopedists and general surgeons. Int Arch Occup Environ Health. 1995;67(3):179–86.

    CAS  PubMed  Google Scholar 

  34. AlQahtani SM, Alzahrani MM, Harvey EJ. Prevalence of musculoskeletal disorders among orthopedic trauma surgeons: an OTA survey. Can J Surg. 2016;59(1):42–7.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Cavanagh J, Brake M, Kearns D, Hong P. Work environment discomfort and injury: an ergonomic survey study of the American Society of Pediatric Otolaryngology members. Am J Otolaryngol. 2012;33(4):441–6. https://doi.org/10.1016/j.amjoto.2011.10.022.

    Article  PubMed  Google Scholar 

  36. Babar-Craig H, Banfield G, Knight J. Prevalence of back and neck pain amongst ENT consultants: national survey. J Laryngol Otol. 2003;117(12):979–82. https://doi.org/10.1258/002221503322683885.

    Article  CAS  PubMed  Google Scholar 

  37. Rimmer J, Amin M, Fokkens WJ, Lund VJ. Endoscopic sinus surgery and musculoskeletal symptoms. Rhinology. 2016;54(2):105–10. https://doi.org/10.4193/Rhin15.217.

    PubMed  Google Scholar 

  38. Wong A, Baker N, Smith L, Rosen CA. Prevalence and risk factors for musculoskeletal problems associated with microlaryngeal surgery: a national survey. Laryngoscope. 2014;124(8):1854–61. https://doi.org/10.1002/lary.24367.

    Article  PubMed  Google Scholar 

  39. Esposito C, Najmaldin A, Schier F, Yamataka A, Ferro M, Riccipetitoni G, et al. Work-related upper limb musculoskeletal disorders in pediatric minimally invasive surgery: a multicentric survey comparing laparoscopic and sils ergonomy. Pediatr Surg Int. 2014;30(4):395–9. https://doi.org/10.1007/s00383-013-3437-y.

    Article  PubMed  Google Scholar 

  40. Filisetti C, Cho A, Riccipetitoni G, Saxena AK. Analysis of hand size and ergonomics of instruments in pediatric minimally invasive surgery. Surg Laparosc Endosc Percutan Tech. 2015;25(5):e159–62. https://doi.org/10.1097/SLE.0000000000000125.

    Article  PubMed  Google Scholar 

  41. Alzahrani MM, Alqahtani SM, Tanzer M, Hamdy RC. Musculoskeletal disorders among orthopedic pediatric surgeons: an overlooked entity. J Child Orthop. 2016;10(5):461–6. https://doi.org/10.1007/s11832-016-0767-z.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Capone AC, Parikh PM, Gatti ME, Davidson BJ, Davison SP. Occupational injury in plastic surgeons. Plast Reconstr Surg. 2010;125(5):1555–61. https://doi.org/10.1097/PRS.0b013e3181d62a94.

    Article  CAS  PubMed  Google Scholar 

  43. Tzeng YS, Chen SG, Chen TM. Herniation of the cervical disk in plastic surgeons. Ann Plast Surg. 2012;69(6):672–4. https://doi.org/10.1097/SAP.0b013e3182742743.

    Article  CAS  PubMed  Google Scholar 

  44. Tjiam IM, Goossens RH, Schout BM, Koldewijn EL, Hendrikx AJ, Muijtjens AM, et al. Ergonomics in endourology and laparoscopy: an overview of musculoskeletal problems in urology. J Endourol. 2014;28(5):605–11. https://doi.org/10.1089/end.2013.0654.

    Article  PubMed  Google Scholar 

  45. Wolf JS Jr, Marcovich R, Gill IS, Sung GT, Kavoussi LR, Clayman RV, et al. Survey of neuromuscular injuries to the patient and surgeon during urologic laparoscopic surgery. Urology. 2000;55(6):831–6.

    Article  PubMed  Google Scholar 

  46. Liang B, Qi L, Yang J, Cao Z, Zu X, Liu L, et al. Ergonomic status of laparoscopic urologic surgery: survey results from 241 urologic surgeons in china. PLoS One. 2013;8(7):e70423. https://doi.org/10.1371/journal.pone.0070423.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Gofrit ON, Mikahail AA, Zorn KC, Zagaja GP, Steinberg GD, Shalhav AL. Surgeons’ perceptions and injuries during and after urologic laparoscopic surgery. Urology. 2008;71(3):404–7. https://doi.org/10.1016/j.urology.2007.07.077.

    Article  PubMed  Google Scholar 

  48. Davila V, Stone W, Hallbeck M, Money S. Physical discomfort in vascular surgeons. Society of clinical vascular surgeons 45th annual symposium, 18–22 Mar.

    Google Scholar 

  49. Davis WT, Fletcher SA, Guillamondegui OD. Musculoskeletal occupational injury among surgeons: effects for patients, providers, and institutions. J Surg Res. 2014;189(2):207–212. e6. https://doi.org/10.1016/j.jss.2014.03.013.

    Article  PubMed  Google Scholar 

  50. Gerr F. Surveillance of work-related musculoskeletal disorders. Occup Environ Med. 2008;65(5):298–9. https://doi.org/10.1136/oem.2007.037515.

    Article  PubMed  Google Scholar 

  51. Davis WT, Sathiyakumar V, Jahangir AA, Obremskey WT, Sethi MK. Occupational injury among orthopaedic surgeons. J Bone Joint Surg Am. 2013;95(15):e107. https://doi.org/10.2106/JBJS.L.01427.

    Article  PubMed  Google Scholar 

  52. Janki S, Mulder EE, JN IJ, Tran TC. Ergonomics in the operating room. Surg Endosc. 2016. https://doi.org/10.1007/s00464-016-5247-5.

  53. Vijendren A, Yung M, Sanchez J. The ill surgeon: a review of common work-related health problems amongst UK surgeons. Langenbeck's Arch Surg. 2014;399(8):967–79. https://doi.org/10.1007/s00423-014-1233-3.

    Article  Google Scholar 

  54. Company MHAH. 2016 Physician inpatient/outpatient revenue survey. https://www.merritthawkins.com/uploadedFiles/MerrittHawkins/Surveys/Merritt_Hawkins-2016_RevSurvey.pdf. 2017.

  55. Howarth A, Hallbeck S, Mahabir R, Lemaine V, Evans G, Noland S. Work-related physical discomfort in ASRM members: a survey. New York: American Society of Reconstructive Microsurgery; 2017.

    Google Scholar 

  56. Park AE, Zahiri HR, Hallbeck MS, Augenstein V, Sutton E, Yu D, et al. Intraoperative Micro Breaks with targeted stretching enhance surgeon physical function and mental focus: a multicenter cohort study. Ann Surg. 2016. https://doi.org/10.1097/SLA.0000000000001665.

  57. The Complexities of Physician Supply and Demand: Projections from 2014 to 2025 [database on the Internet]. IHS Inc. Accessed.

    Google Scholar 

  58. ACGME program requirements for graduate medical education in general surgery. Accreditation Council for Graduate Medical Education. 2016.

    Google Scholar 

  59. Yoong W, Sanchez-Crespo J, Rob J, Parikh M, Melendez J, Pillai R, et al. Sticks and stones may break my bones: work-related orthopaedic injuries sustained during obstetrics and gynaecology training. J Obstet Gynaecol. 2008;28(5):478–81. https://doi.org/10.1080/01443610802091396.

    Article  CAS  PubMed  Google Scholar 

  60. Balch CM, Freischlag JA, Shanafelt TD. Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences. Arch Surg. 2009;144(4):371–6. https://doi.org/10.1001/archsurg.2008.575.

    Article  PubMed  Google Scholar 

  61. Shanafelt TD, Balch CM, Bechamps GJ, Russell T, Dyrbye L, Satele D, et al. Burnout and career satisfaction among American surgeons. Ann Surg. 2009;250(3):463–71. https://doi.org/10.1097/SLA.0b013e3181ac4dfd.

    PubMed  Google Scholar 

  62. Armon G, Melamed S, Shirom A, Shapira I. Elevated burnout predicts the onset of musculoskeletal pain among apparently healthy employees. J Occup Health Psychol. 2010;15(4):399–408. https://doi.org/10.1037/a0020726.

    Article  PubMed  Google Scholar 

  63. Berguer R, Rab GT, Abu-Ghaida H, Alarcon A, Chung J. A comparison of surgeons’ posture during laparoscopic and open surgical procedures. Surg Endosc. 1997;11(2):139–42.

    Article  CAS  PubMed  Google Scholar 

  64. Berguer R, Smith WD, Chung YH. Performing laparoscopic surgery is significantly more stressful for the surgeon than open surgery. Surg Endosc. 2001;15(10):1204–7. https://doi.org/10.1007/s004640080030.

    Article  CAS  PubMed  Google Scholar 

  65. Wang R, Liang Z, Zihni AM, Ray S, Awad MM. Which causes more ergonomic stress: laparoscopic or open surgery? Surg Endosc. 2016. https://doi.org/10.1007/s00464-016-5360-5.

  66. Kant IJ, de Jong LC, van Rijssen-Moll M, Borm PJ. A survey of static and dynamic work postures of operating room staff. Int Arch Occup Environ Health. 1992;63(6):423–8.

    Article  CAS  PubMed  Google Scholar 

  67. Kelsey JL, Githens PB, White AA 3rd, Holford TR, Walter SD, O’Connor T, et al. An epidemiologic study of lifting and twisting on the job and risk for acute prolapsed lumbar intervertebral disc. J Orthop Res. 1984;2(1):61–6. https://doi.org/10.1002/jor.1100020110.

    Article  CAS  PubMed  Google Scholar 

  68. Ng JK, Richardson CA, Parnianpour M, Kippers V. EMG activity of trunk muscles and torque output during isometric axial rotation exertion: a comparison between back pain patients and matched controls. J Orthop Res. 2002;20(1):112–21. https://doi.org/10.1016/S0736-0266(01)00067-5.

    Article  PubMed  Google Scholar 

  69. Szeto GP, Cheng SW, Poon JT, Ting AC, Tsang RC, Ho P. Surgeons’ static posture and movement repetitions in open and laparoscopic surgery. J Surg Res. 2012;172(1):e19–31. https://doi.org/10.1016/j.jss.2011.08.004.

    Article  PubMed  Google Scholar 

  70. McGill SM, Hughson RL, Parks K. Lumbar erector spinae oxygenation during prolonged contractions: implications for prolonged work. Ergonomics. 2000;43(4):486–93. https://doi.org/10.1080/001401300184369.

    Article  CAS  PubMed  Google Scholar 

  71. Nguyen NT, Ho HS, Smith WD, Philipps C, Lewis C, De Vera RM, et al. An ergonomic evaluation of surgeons’ axial skeletal and upper extremity movements during laparoscopic and open surgery. Am J Surg. 2001;182(6):720–4.

    Article  CAS  PubMed  Google Scholar 

  72. Uhrich ML, Underwood RA, Standeven JW, Soper NJ, Engsberg JR. Assessment of fatigue, monitor placement, and surgical experience during simulated laparoscopic surgery. Surg Endosc. 2002;16(4):635–9. https://doi.org/10.1007/s00464-001-8151-5.

    Article  CAS  PubMed  Google Scholar 

  73. Berguer R, Forkey DL, Smith WD. The effect of laparoscopic instrument working angle on surgeons’ upper extremity workload. Surg Endosc. 2001;15(9):1027–9. https://doi.org/10.1007/s00464-001-0019-1.

    Article  CAS  PubMed  Google Scholar 

  74. Boppart SA, Deutsch TF, Rattner DW. Optical imaging technology in minimally invasive surgery. Current status and future directions. Surg Endosc. 1999;13(7):718–22.

    Article  CAS  PubMed  Google Scholar 

  75. Elfering A, Grebner S, Gerber H, Semmer NK. Workplace observation of work stressors, catecholamines and musculoskeletal pain among male employees. Scand J Work Environ Health. 2008;34(5):337–44.

    Article  PubMed  Google Scholar 

  76. Albayrak K, Meijer B. Current state of ergonomics of operating rooms of Dutch hospitals in the endoscopic era. Minim Invasive Ther Allied Technol. 2004;13(3):156–60. https://doi.org/10.1080/13645700410034093.

    Article  CAS  PubMed  Google Scholar 

  77. Kranenburg G. Ergonomic problems encountered during video-assisted thoracic surgery. Minim Invasive Ther Allied Technol. 2004;13(3):147–55. https://doi.org/10.1080/13645700410033661.

    Article  CAS  PubMed  Google Scholar 

  78. Reyes DA, Tang B, Cuschieri A. Minimal access surgery (MAS)-related surgeon morbidity syndromes. Surg Endosc. 2006;20(1):1–13. https://doi.org/10.1007/s00464-005-0315-2.

    Article  CAS  PubMed  Google Scholar 

  79. Ballantyne GH. The pitfalls of laparoscopic surgery: challenges for robotics and telerobotic surgery. Surg Laparosc Endosc Percutan Tech. 2002;12(1):1–5.

    Article  PubMed  Google Scholar 

  80. Sánchez-Margallo F, Sánchez-Margallo J. Ergonomics in laparoscopic surgery. In: Malik AM, editor. Laparoscopic surgery: InTech; 2017.

    Google Scholar 

  81. Yu D, Dural C, Morrow MM, Yang L, Collins JW, Hallbeck S, et al. Intraoperative workload in robotic surgery assessed by wearable motion tracking sensors and questionnaires. Surg Endosc. 2017;31(2):877–86. https://doi.org/10.1007/s00464-016-5047-y.

    Article  PubMed  Google Scholar 

  82. Craven R, Franasiak J, Mosaly P, Gehrig PA. Ergonomic deficits in robotic gynecologic oncology surgery: a need for intervention. J Minim Invasive Gynecol. 2013;20(5):648–55. https://doi.org/10.1016/j.jmig.2013.04.008.

    Article  PubMed  Google Scholar 

  83. Lee GI, Lee MR, Green I, Allaf M, Marohn MR. Surgeons’ physical discomfort and symptoms during robotic surgery: a comprehensive ergonomic survey study. Surg Endosc. 2017;31(4):1697–706. https://doi.org/10.1007/s00464-016-5160-y.

    Article  CAS  PubMed  Google Scholar 

  84. Lux MM, Marshall M, Erturk E, Joseph JV. Ergonomic evaluation and guidelines for use of the daVinci Robot system. J Endourol. 2010;24(3):371–5. https://doi.org/10.1089/end.2009.0197.

    Article  PubMed  Google Scholar 

  85. Sillanpaa J, Nyberg M, Laippala P. A new table for work with a microscope, a solution to ergonomic problems. Appl Ergon. 2003;34(6):621–8. https://doi.org/10.1016/S0003-6870(03)00051-6.

    Article  PubMed  Google Scholar 

  86. Webb Associates Yellow Springs Ohio. Anthropology Research Project. A Handbook of anthropometric data. Anthropometric source book, vol 2. Washington Springfield: National Aeronautics and Space Administration for sale by the National Technical Information Service; 1978.

    Google Scholar 

  87. Webb Associates Yellow Springs Ohio. Anthropology Research Project. Anthropometry for designers. Anthropometric source book, vol 1. Washington Springfield: National Aeronautics and Space Administration for sale by the National Technical Information Service; 1978.

    Google Scholar 

  88. Berguer R, Hreljac A. The relationship between hand size and difficulty using surgical instruments: a survey of 726 laparoscopic surgeons. Surg Endosc. 2004;18(3):508–12. https://doi.org/10.1007/s00464-003-8824-3.

    Article  CAS  PubMed  Google Scholar 

  89. Sutton E, Irvin M, Zeigler C, Lee G, Park A. The ergonomics of women in surgery. Surg Endosc. 2014;28(4):1051–5. https://doi.org/10.1007/s00464-013-3281-0.

    Article  PubMed  Google Scholar 

  90. Voss RK, Chiang YJ, Cromwell KD, Urbauer DL, Lee JE, Cormier JN, et al. Do no harm, except to ourselves? A survey of symptoms and injuries in oncologic surgeons and pilot study of an intraoperative ergonomic intervention. J Am Coll Surg. 2017;224(1):16–25. e1. https://doi.org/10.1016/j.jamcollsurg.2016.09.013.

    Article  PubMed  Google Scholar 

  91. Aitchison LP, Cui CK, Arnold A, Nesbitt-Hawes E, Abbott J. The ergonomics of laparoscopic surgery: a quantitative study of the time and motion of laparoscopic surgeons in live surgical environments. Surg Endosc. 2016;30(11):5068–76. https://doi.org/10.1007/s00464-016-4855-4.

    Article  PubMed  Google Scholar 

  92. Strazdins L, Bammer G. Women, work and musculoskeletal health. Soc Sci Med. 2004;58(6):997–1005.

    Article  PubMed  Google Scholar 

  93. Szeto GP, Lam P. Work-related musculoskeletal disorders in urban bus drivers of Hong Kong. J Occup Rehabil. 2007;17(2):181–98. https://doi.org/10.1007/s10926-007-9070-7.

    Article  PubMed  Google Scholar 

  94. Anderson R. The back pain of bus drivers. Prevalence in an urban area of California. Spine (Phila Pa 1976). 1992;17(12):1481–8.

    Article  CAS  Google Scholar 

  95. Lee G, Lee T, Dexter D, Godinez C, Meenaghan N, Catania R, et al. Ergonomic risk associated with assisting in minimally invasive surgery. Surg Endosc. 2009;23(1):182–8. https://doi.org/10.1007/s00464-008-0141-4.

    Article  PubMed  Google Scholar 

  96. Zihni AM, Cavallo JA, Ray S, Ohu I, Cho S, Awad MM. Ergonomic analysis of primary and assistant surgical roles. J Surg Res. 2016;203(2):301–5. https://doi.org/10.1016/j.jss.2016.03.058.

    Article  PubMed  Google Scholar 

  97. Park JY, Kim KH, Kuh SU, Chin DK, Kim KS, Cho YE. Spine surgeon’s kinematics during discectomy according to operating table height and the methods to visualize the surgical field. Eur Spine J. 2012;21(12):2704–12. https://doi.org/10.1007/s00586-012-2425-6.

    Article  PubMed  PubMed Central  Google Scholar 

  98. Matern U, Faist M, Kehl K, Giebmeyer C, Buess G. Monitor position in laparoscopic surgery. Surg Endosc. 2005;19(3):436–40. https://doi.org/10.1007/s00464-004-9030-7.

    Article  CAS  PubMed  Google Scholar 

  99. Xiao DJ, Jakimowicz JJ, Albayrak A, Goossens RH. Ergonomic factors on task performance in laparoscopic surgery training. Appl Ergon. 2012;43(3):548–53. https://doi.org/10.1016/j.apergo.2011.08.010.

    Article  CAS  PubMed  Google Scholar 

  100. Bhatnager V, Drury CG, Schiro SG. Posture, postural discomfort, and performance. Hum Factors. 1985;27(2):189–99. https://doi.org/10.1177/001872088502700206.

    Article  CAS  PubMed  Google Scholar 

  101. Ernst E, Canter PH. The Alexander technique: a systematic review of controlled clinical trials. Forsch Komplementarmed Klass Naturheilkd. 2003;10(6):325–9. doi:75886

    CAS  PubMed  Google Scholar 

  102. Reddy PP, Reddy TP, Roig-Francoli J, Cone L, Sivan B, DeFoor WR, et al. The impact of the alexander technique on improving posture and surgical ergonomics during minimally invasive surgery: pilot study. J Urol. 2011;186(4 Suppl):1658–62. https://doi.org/10.1016/j.juro.2011.04.013.

    Article  PubMed  Google Scholar 

  103. Bauer W, Wittig T. Influence of screen and copy holder positions on head posture, muscle activity and user judgement. Appl Ergon. 1998;29(3):185–92.

    Article  CAS  PubMed  Google Scholar 

  104. Seghers J, Jochem A, Spaepen A. Posture, muscle activity and muscle fatigue in prolonged VDT work at different screen height settings. Ergonomics. 2003;46(7):714–30. https://doi.org/10.1080/0014013031000090107.

    Article  PubMed  Google Scholar 

  105. Turville KL, Psihogios JP, Ulmer TR, Mirka GA. The effects of video display terminal height on the operator: a comparison of the 15 degree and 40 degree recommendations. Appl Ergon. 1998;29(4):239–46.

    Article  CAS  PubMed  Google Scholar 

  106. Matern U, Waller P. Instruments for minimally invasive surgery: principles of ergonomic handles. Surg Endosc. 1999;13(2):174–82.

    Article  CAS  PubMed  Google Scholar 

  107. van Veelen MA, Kazemier G, Koopman J, Goossens RH, Meijer DW. Assessment of the ergonomically optimal operating surface height for laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 2002;12(1):47–52. https://doi.org/10.1089/109264202753486920.

    Article  PubMed  Google Scholar 

  108. Rosenblatt PL, McKinney J, Adams SR. Ergonomics in the operating room: protecting the surgeon. J Minim Invasive Gynecol. 2013;20(6):744. https://doi.org/10.1016/j.jmig.2013.07.006.

    Article  PubMed  Google Scholar 

  109. Graversen JA, Korets R, Mues AC, Katsumi HK, Badani KK, Landman J, et al. Prospective randomized evaluation of gel mat foot pads in the endoscopic suite. J Endourol. 2011;25(11):1793–6. https://doi.org/10.1089/end.2011.0155.

    Article  PubMed  Google Scholar 

  110. Cook J, Branch TP, Baranowski TJ, Hutton WC. The effect of surgical floor mats in prolonged standing: an EMG study of the lumbar paraspinal and anterior tibialis muscles. J Biomed Eng. 1993;15(3):247–50.

    Article  CAS  PubMed  Google Scholar 

  111. Aghazadeh J, Ghaderi M, Azghani MR, Khalkhali HR, Allahyari T, Mohebbi I. Anti-fatigue mats, low back pain, and electromyography: An interventional study. Int J Occup Med Environ Health. 2015;28(2):347–56. 10.13075/ijomeh.1896.00311.

    PubMed  Google Scholar 

  112. Dul J, Weerdmeester BA. Ergonomics for beginners : a quick reference guide. 2nd ed. London/New York: Taylor & Francis; 2003.

    Google Scholar 

  113. Jafri M, Brown S, Arnold G, Abboud R, Wang W. Kinematical analysis of the trunk, upper limbs and fingers during minimal access surgery when using an armrest. Ergonomics. 2015;58(11):1868–77. https://doi.org/10.1080/00140139.2015.1039603.

    Article  PubMed  Google Scholar 

  114. van Det MJ, Meijerink WJ, Hoff C, Totte ER, Pierie JP. Optimal ergonomics for laparoscopic surgery in minimally invasive surgery suites: a review and guidelines. Surg Endosc. 2009;23(6):1279–85. https://doi.org/10.1007/s00464-008-0148-x.

    Article  PubMed  Google Scholar 

  115. El Shallaly G, Cuschieri A. Optimum view distance for laparoscopic surgery. Surg Endosc. 2006;20(12):1879–82. https://doi.org/10.1007/s00464-005-0162-1.

    Article  PubMed  Google Scholar 

  116. Kelts GI, McMains KC, Chen PG, Weitzel EK. Monitor height ergonomics: a comparison of operating room video display terminals. Allergy Rhinol (Providence). 2015;6(1):28–32. https://doi.org/10.2500/ar.2015.6.0119.

    Article  Google Scholar 

  117. van Det MJ, Meijerink WJ, Hoff C, van Veelen MA, Pierie JP. Ergonomic assessment of neck posture in the minimally invasive surgery suite during laparoscopic cholecystectomy. Surg Endosc. 2008;22(11):2421–7. https://doi.org/10.1007/s00464-008-0042-6.

    Article  PubMed  Google Scholar 

  118. Erfanian K, Luks FI, Kurkchubasche AG, Wesselhoeft CW Jr, Tracy TF Jr. In-line image projection accelerates task performance in laparoscopic appendectomy. J Pediatr Surg. 2003;38(7):1059–62.

    Article  PubMed  Google Scholar 

  119. Zehetner J, Kaltenbacher A, Wayand W, Shamiyeh A. Screen height as an ergonomic factor in laparoscopic surgery. Surg Endosc. 2006;20(1):139–41. https://doi.org/10.1007/s00464-005-0251-1.

    Article  CAS  PubMed  Google Scholar 

  120. Jaschinski-Kruza W. Eyestrain in VDU users: viewing distance and the resting position of ocular muscles. Hum Factors. 1991;33(1):69–83. https://doi.org/10.1177/001872089103300106.

    Article  CAS  PubMed  Google Scholar 

  121. Omar AM, Wade NJ, Brown SI, Cuschieri A. Assessing the benefits of “gaze-down” display location in complex tasks. Surg Endosc. 2005;19(1):105–8. https://doi.org/10.1007/s00464-004-8141-5.

    Article  CAS  PubMed  Google Scholar 

  122. Hanna GB, Shimi SM, Cuschieri A. Task performance in endoscopic surgery is influenced by location of the image display. Ann Surg. 1998;227(4):481–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  123. Haveran LA, Novitsky YW, Czerniach DR, Kaban GK, Taylor M, Gallagher-Dorval K, et al. Optimizing laparoscopic task efficiency: the role of camera and monitor positions. Surg Endosc. 2007;21(6):980–4. https://doi.org/10.1007/s00464-007-9360-3.

    Article  PubMed  Google Scholar 

  124. Kroemer KH, Hill SG. Preferred line of sight angle. Ergonomics. 1986;29(9):1129–34. https://doi.org/10.1080/00140138608967228.

    Article  CAS  PubMed  Google Scholar 

  125. Hill SG, Kroemer KH. Preferred declination of the line of sight. Hum Factors. 1986;28(2):127–34. https://doi.org/10.1177/001872088602800201.

    Article  CAS  PubMed  Google Scholar 

  126. Sommerich CM, Joines SM, Psihogios JP. Effects of computer monitor viewing angle and related factors on strain, performance, and preference outcomes. Hum Factors. 2001;43(1):39–55. https://doi.org/10.1518/001872001775992480.

    Article  CAS  PubMed  Google Scholar 

  127. Ripple PH. Variation of accommodation in vertical directions of gaze. Am J Ophthalmol. 1952;35(11):1630–4.

    Article  CAS  PubMed  Google Scholar 

  128. Rodigari A, Bejor M, Carlisi E, Lisi C, Tinelli C, Toffola ED. Identification of risk factors for fatigue and pain when performing surgical interventions. G Ital Med Lav Ergon. 2012;34(4):432–7.

    PubMed  Google Scholar 

  129. Ayoub MM. Work place design and posture. Hum Factors. 1973;15(3):265–8. https://doi.org/10.1177/001872087301500309.

    Article  CAS  PubMed  Google Scholar 

  130. Matern U, Waller P, Giebmeyer C, Ruckauer KD, Farthmann EH. Ergonomics: requirements for adjusting the height of laparoscopic operating tables. JSLS. 2001;5(1):7–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  131. Berquer R, Smith WD, Davis S. An ergonomic study of the optimum operating table height for laparoscopic surgery. Surg Endosc. 2002;16(3):416–21. https://doi.org/10.1007/s00464-001-8190-y.

    Article  CAS  PubMed  Google Scholar 

  132. Manasnayakorn S, Cuschieri A, Hanna GB. Ergonomic assessment of optimum operating table height for hand-assisted laparoscopic surgery. Surg Endosc. 2009;23(4):783–9. https://doi.org/10.1007/s00464-008-0068-9.

    Article  PubMed  Google Scholar 

  133. van Veelen MA, Snijders CJ, van Leeuwen E, Goossens RH, Kazemier G. Improvement of foot pedals used during surgery based on new ergonomic guidelines. Surg Endosc. 2003;17(7):1086–91. https://doi.org/10.1007/s00464-002-9185-z.

    Article  PubMed  Google Scholar 

  134. Gordon DJ, Wilkinson P. Prolonged use of a surgical retractor causing neuropathy in an assistant. J R Coll Surg Edinb. 1991;36(2):132.

    CAS  PubMed  Google Scholar 

  135. Sackier JM, Berci G. A laparoscopic hazard for the surgeon. Br J Surg. 1992;79(7):713.

    Article  CAS  PubMed  Google Scholar 

  136. Steele PR, Curran JF, Mountain RE. Current and future practices in surgical retraction. Surgeon. 2013;11(6):330–7. https://doi.org/10.1016/j.surge.2013.06.004.

    Article  CAS  PubMed  Google Scholar 

  137. Blackwell JR, Kornatz KW, Heath EM. Effect of grip span on maximal grip force and fatigue of flexor digitorum superficialis. Appl Ergon. 1999;30(5):401–5.

    Article  CAS  PubMed  Google Scholar 

  138. Putzer D, Klug S, Haselbacher M, Mayr E, Nogler M. Retracting soft tissue in minimally invasive hip arthroplasty using a robotic arm: a comparison between a semiactive retractor holder and human assistants in a cadaver study. Surg Innov. 2015;22(5):500–7. https://doi.org/10.1177/1553350615586110.

    Article  PubMed  Google Scholar 

  139. Chang BJ. Ergonomic benefits of surgical telescope systems: selection guidelines. J Calif Dent Assoc. 2002;30(2):161–9.

    CAS  PubMed  Google Scholar 

  140. Alexandre D, Prieto M, Beaumont F, Taiar R, Polidori G. Wearing lead aprons in surgical operating rooms: ergonomic injuries evidenced by infrared thermography. J Surg Res. 2017;209:227–33. https://doi.org/10.1016/j.jss.2016.10.019.

    Article  PubMed  Google Scholar 

  141. van Veelen MA, Nederlof EA, Goossens RH, Schot CJ, Jakimowicz JJ. Ergonomic problems encountered by the medical team related to products used for minimally invasive surgery. Surg Endosc. 2003;17(7):1077–81. https://doi.org/10.1007/s00464-002-9105-2.

    Article  PubMed  Google Scholar 

  142. Moore B, van Sonnenberg E, Casola G, Novelline RA. The relationship between back pain and lead apron use in radiologists. AJR Am J Roentgenol. 1992;158(1):191–3. https://doi.org/10.2214/ajr.158.1.1530763.

    Article  CAS  PubMed  Google Scholar 

  143. Pelz DM. Low back pain, lead aprons, and the angiographer. AJNR Am J Neuroradiol. 2000;21(7):1364.

    CAS  PubMed  Google Scholar 

  144. Small K, Mc Naughton L, Matthews M. A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury. Res Sports Med. 2008;16(3):213–31. https://doi.org/10.1080/15438620802310784.

    Article  PubMed  Google Scholar 

  145. Neiva HP, Marques MC, Barbosa TM, Izquierdo M, Marinho DA. Warm-up and performance in competitive swimming. Sports Med. 2014;44(3):319–30. https://doi.org/10.1007/s40279-013-0117-y.

    Article  PubMed  Google Scholar 

  146. Lee JY, Mucksavage P, Kerbl DC, Osann KE, Winfield HN, Kahol K, et al. Laparoscopic warm-up exercises improve performance of senior-level trainees during laparoscopic renal surgery. J Endourol. 2012;26(5):545–50. https://doi.org/10.1089/end.2011.0418.

    Article  PubMed  PubMed Central  Google Scholar 

  147. Chen CC, Green IC, Colbert-Getz JM, Steele K, Chou B, Lawson SM, et al. Warm-up on a simulator improves residents' performance in laparoscopic surgery: a randomized trial. Int Urogynecol J. 2013;24(10):1615–22. https://doi.org/10.1007/s00192-013-2066-2.

    Article  CAS  PubMed  Google Scholar 

  148. Abdalla G, Moran-Atkin E, Chen G, Schweitzer MA, Magnuson TH, Steele KE. The effect of warm-up on surgical performance: a systematic review. Surg Endosc. 2015;29(6):1259–69. https://doi.org/10.1007/s00464-014-3811-4.

    Article  PubMed  Google Scholar 

  149. Lendvay TS, Brand TC, White L, Kowalewski T, Jonnadula S, Mercer LD, et al. Virtual reality robotic surgery warm-up improves task performance in a dry laboratory environment: a prospective randomized controlled study. J Am Coll Surg. 2013;216(6):1181–92. https://doi.org/10.1016/j.jamcollsurg.2013.02.012.

    Article  PubMed  PubMed Central  Google Scholar 

  150. Moran-Atkin E, Abdalla G, Chen G, Magnuson TH, Lidor AO, Schweitzer MA, et al. Preoperative warm-up the key to improved resident technique: a randomized study. Surg Endosc. 2015;29(5):1057–63. https://doi.org/10.1007/s00464-014-3778-1.

    Article  PubMed  Google Scholar 

  151. Varela-Mato V, Yates T, Stensel DJ, Biddle SJ, Clemes SA. Time spent sitting during and outside working hours in bus drivers: a pilot study. Prev Med Rep. 2016;3:36–9. https://doi.org/10.1016/j.pmedr.2015.11.011.

    Article  PubMed  Google Scholar 

  152. Caldwell JA, Mallis MM, Caldwell JL, Paul MA, Miller JC, Neri DF, et al. Fatigue countermeasures in aviation. Aviat Space Environ Med. 2009;80(1):29–59.

    Article  PubMed  Google Scholar 

  153. Fatigue Management for Nuclear Power Plant Personnel. US Nuclear Regulator Commission Regulator Guide 2009;March(5.73).

    Google Scholar 

  154. Dorion D, Darveau S. Do micropauses prevent surgeon’s fatigue and loss of accuracy associated with prolonged surgery? An experimental prospective study. Ann Surg. 2013;257(2):256–9. https://doi.org/10.1097/SLA.0b013e31825efe87.

    Article  PubMed  Google Scholar 

  155. Engelmann C, Schneider M, Kirschbaum C, Grote G, Dingemann J, Schoof S, et al. Effects of intraoperative breaks on mental and somatic operator fatigue: a randomized clinical trial. Surg Endosc. 2011;25(4):1245–50. https://doi.org/10.1007/s00464-010-1350-1.

    Article  PubMed  Google Scholar 

  156. Hallbeck MS, Lowndes BR, Bingener J, Abdelrahman AM, Yu D, Bartley A, et al. The impact of intraoperative microbreaks with exercises on surgeons: a multi-center cohort study. Appl Ergon. 2017;60:334–41. https://doi.org/10.1016/j.apergo.2016.12.006.

    Article  CAS  PubMed  Google Scholar 

  157. Micheo W, Baerga L, Miranda G. Basic principles regarding strength, flexibility, and stability exercises. PM R. 2012;4(11):805–11. https://doi.org/10.1016/j.pmrj.2012.09.583.

    Article  PubMed  Google Scholar 

  158. Zheng B, Martinec DV, Cassera MA, Swanstrom LL. A quantitative study of disruption in the operating room during laparoscopic antireflux surgery. Surg Endosc. 2008;22(10):2171–7. https://doi.org/10.1007/s00464-008-0017-7.

    Article  PubMed  Google Scholar 

  159. Woo EH, White P, Lai CW. Ergonomics standards and guidelines for computer workstation design and the impact on users’ health – a review. Ergonomics. 2016;59(3):464–75. https://doi.org/10.1080/00140139.2015.1076528.

    Article  CAS  PubMed  Google Scholar 

  160. Bleecker ML, Celio MA, Barnes SK. A medical-ergonomic program for symptomatic keyboard/mouse users. J Occup Environ Med. 2011;53(5):562–8. https://doi.org/10.1097/JOM.0b013e31821719af.

    Article  PubMed  Google Scholar 

  161. Rempel DM, Keir PJ, Bach JM. Effect of wrist posture on carpal tunnel pressure while typing. J Orthop Res. 2008;26(9):1269–73. https://doi.org/10.1002/jor.20599.

    Article  PubMed  PubMed Central  Google Scholar 

  162. Keir PJ, Bach JM, Hudes M, Rempel DM. Guidelines for wrist posture based on carpal tunnel pressure thresholds. Hum Factors. 2007;49(1):88–99. https://doi.org/10.1518/001872007779598127.

    Article  PubMed  Google Scholar 

  163. Feuerstein M, Armstrong T, Hickey P, Lincoln A. Computer keyboard force and upper extremity symptoms. J Occup Environ Med. 1997;39(12):1144–53.

    Article  CAS  PubMed  Google Scholar 

  164. Tse MA, Masters RS, McManus AM, Lo CY, Patil NG. Trunk muscle training, posture fatigue, and performance in laparoscopic surgery. J Endourol. 2008;22(5):1053–8. https://doi.org/10.1089/end.2007.0409.

    Article  PubMed  Google Scholar 

  165. Andersen LL, Kjaer M, Sogaard K, Hansen L, Kryger AI, Sjogaard G. Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthritis Rheum. 2008;59(1):84–91. https://doi.org/10.1002/art.23256.

    Article  PubMed  Google Scholar 

  166. Sculco AD, Paup DC, Fernhall B, Sculco MJ. Effects of aerobic exercise on low back pain patients in treatment. Spine J. 2001;1(2):95–101.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This material is the result of work supported with resources and use of facilities at the Minneapolis VA Health Care System.

Disclaimer

The contents of this publication do not represent the views of the US Department of Veterans Affairs or the US government.

Author information

Authors and Affiliations

  1. University of Minnesota Medical School, 420 Delaware Street SE, Minneapolis, MN, 55455, USA

    Carrie Ronstrom MD

  2. Department of Health Sciences Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA

    Susan Hallbeck PhD, PE, CPE & Bethany Lowndes PhD, MPH

  3. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Susan Hallbeck PhD, PE, CPE & Bethany Lowndes PhD, MPH

  4. Department of Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Susan Hallbeck PhD, PE, CPE

  5. Minneapolis VA Health Care Center, University of Minnesota, Department of Urology, 420 Delaware St SE, Minneapolis, MN, 55455, USA

    Kristin L. Chrouser MD, MPH

Authors
  1. Carrie Ronstrom MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susan Hallbeck PhD, PE, CPE
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bethany Lowndes PhD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kristin L. Chrouser MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carrie Ronstrom MD .

Editor information

Editors and Affiliations

  1. Urology, Mayo Clinic, Rochester, Minnesota, USA

    Tobias S. Köhler

  2. Department of Surgery, Urology, Southern Illinois University School of Medicine, Springfield, Illinois, USA

    Bradley Schwartz

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Ronstrom, C., Hallbeck, S., Lowndes, B., Chrouser, K.L. (2018). Surgical Ergonomics. In: Köhler, T., Schwartz, B. (eds) Surgeons as Educators . Springer, Cham. https://doi.org/10.1007/978-3-319-64728-9_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-64728-9_22

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64727-2

  • Online ISBN: 978-3-319-64728-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation