Adrian Park, MD, is chair of the department of surgery at Anne Arundel Medical System in Annapolis, Md. He spoke to Becker's Spine Review about work-related injuries affecting surgical specialists.
Note: Responses were lightly edited for style and clarity.
Question: Which surgical specialties are most likely to experience work-related musculoskeletal pain and injuries?
Dr. Adrian Park: Pain and injuries during surgery have been documented across a broad spectrum of surgical specialties. Often surgeons have to assume static postures for long periods of time during the course of their surgical workday.
For specific specialties, pain and injuries can result from equipment required to perform the surgery. Surgeons who have to wear protective clothing such as heavy lead "aprons" when X-rays are used intraoperatively during various types of orthopedic and spine surgeries or vascular surgery, for example, often suffer chronic neck and back pain and injuries. Surgeons who perform various types of laparoscopic surgery (e.g., gynecologic, urologic and general minimally invasive surgery) and use long, non-articulating instruments, are often forced to assume awkward positions or stress their wrists for prolonged periods of time. For surgeons performing multiple surgeries per week throughout their career, this can cause serious long-term physical stress on the bod, resulting in serious injuries.
Q: Have you personally experienced back problems or pain related to modern surgical techniques? If so, how did that affect your practice?
AP: Unfortunately, I've experienced firsthand the consequences of sustained ergonomic risk factor violations from simply performing a large volume of advanced laparoscopic procedures over many years. I developed wrist problems and ultimately required carpal tunnel surgery on both my wrists. Following each surgery, I was out of the operating room five to six weeks postoperatively, totaling 10 to 12 weeks over a couple of years during which I could not operate.
Q: What can surgery department leaders do to help their teams avoid the physical strain linked to minimal-access procedures?
AP: Today, there is a significant and appropriate focus on mental well-being and burnout among physicians. While these are serious concerns that need to be addressed, we also need to discuss the physical demands that come with performing surgery and the injuries that surgeons are at risk of by simply going to work every week. As a surgical community, we need to create a safe and open environment for discussion of this growing epidemic of surgeon injury. We need to encourage surgeons to participate in education and research opportunities. Increasing surgeon awareness of this problem is needed through teaching conferences, grand rounds, etc., to address the physical demands of surgery and how to mitigate the risk of pain and injury by an understanding and adoption of sound surgical ergonomic principles. Although much more research needs to be done, we do know how to optimize OR table, equipment, surgeon and team positioning. There are stretching microbreaks that can be employed regularly during the course of an operation, with proven beneficial results. So, there are steps that can now be taken, although much more attention and resources need to be brought to this important issue.
Want to participate in future Q&As? Email Angie Stewart: astewart@beckershealthcare.com.
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