OR ergonomics may optimize performance, minimize fatigue for surgical team
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Surgeons should play an active role in optimizing performance and minimizing fatigue and injury of their surgical teams by being aware of ergonomics in the OR, according to a presenter at the Women in Medicine Summit.
Audrey Tsao, MD, noted it is important to have an ergonomic time out prior to surgery to confirm surgical and patient information, as well as surgeon preferences.
“I identify that I am right-handed. I identify where I want my accessory things. My team knows that I put a lot of additional stuff in, and I identify additional pockets, Mayo stands, etc., for whatever I need. I use these to avoid reaching in awkward postures and positions and keep neutral heights and optimize my assistants as much as I physically can,” Tsao, of the Mid-Atlantic Permanente Medical Group, said in her presentation.
s of their assistants and techs to accommodate for injury and height.
“You want to mentally consider optimal body positions for yourself and your team,” Tsao said. “Anything that you have to do more than twice, you might want to rethink it at the end of the surgery, and you might want to rethink a different way of doing it.”
Tsao noted surgeons need to be aware of their height and to adjust the OR table and lights to benefit them ergonomically. Surgeons who are shorter may want to use stepstools or a platform to accommodate them, she said. While powered equipment can be beneficial to surgeons who do not have as much upper body strength and leverage, they need to be aware that powered equipment will add weight to the instruments, which will change the leverage, torque and vibration, according to Tsao.
“This requires a different skillset to learn how to operate if you are not natural to this,” Tsao said.
In addition, assistants should also be ergonomically equipped for the surgery. Tsao noted her assistants use an ergonomic pouch that holds their instruments directly on their chests.
“They have their ergonomics; they can reach things. They are not reaching over because it is a reach for them, as well to go down, and they have everything that they need in the appropriate position,” Tsao said. “They are comfortable and their fatigue level and their endurance for surgery is better.”
She noted medical students, residents or those in early training should identify which instruments provide the best advantages in the OR by testing the instruments outside of surgery.
“You are allowed to ask for that instrument to assist your attending, assist the surgeon and assist your team,” Tsao said.
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Pentico M, et al. Surgery and ergonomics: Maximizing your capacity, while protecting yourself. Presented at: Women in Medicine Summit; Sept. 24-25, 2021 (virtual meeting).
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