Optimising ergonomics in minimally invasive gynaecological surgery: a comprehensive review and practice recommendations

Abstract

Background: Modern minimally invasive gynaecological surgery greatly contributes to women's health; however, it can be physically demanding for surgeons. A plethora of available data shows that the optimisation of ergonomics in the operating room (OR) is crucial for the health and efficiency of surgeons. Objectives: To provide an overview of the importance of ergonomics and clinically useful, concise recommendations. Methods: A literature review with critical analysis of available data. Main Outcome Measures: Impact of ergonomics on the prevalence of musculoskeletal disorders (MSDs), fatigue levels, efficiency and subjective comfort among surgeons. Results: Evidence suggests that MSDs are highly prevalent among minimally invasive gynaecological surgeons and that several ergonomic interventions can greatly reduce muscle strain and improve clinical practice, with the most important being the planning of brief intraoperative breaks, the selection of proper laparoscopic instruments and the positioning of the operating table and monitor at the correct height. The adoption of robotic surgery can also improve surgical ergonomics. Clinical practice recommendations for ergonomic improvement in gynaecological laparoscopy based on the existing evidence are provided. Conclusions: Surgeons must be aware of the optimal ergonomic settings in the OR and impose measures to reduce risks and achieve a comfortable environment. What is New?: A comprehensive, praxis-oriented review with exact ergonomic advice for minimally invasive gynaecological surgeons.