An Ergonomic Evaluation of Surgeons during Laparoscopic and Open Surgery in a General Hospital in Tehran, Iran, and Presentation of Corrective Measures in 2016

Introduction and purpose: Surgeons are exposed to different risk factors for musculoskeletal disorders (MSDs) due to their occupational nature. The aim of the current research was to investigate the ergonomics of surgeons during laparoscopic and open surgeries and present applicable ergonomic strategies for the reduction of MSDs risk factors among this population. This cross-sectional study was conducted on 85 surgeons, performing laparoscopic and open surgeries, in one of the general hospitals of Tehran, Iran, in 2016. The participants were assessed by means of two ergonomic assessment methods, namely Rapid Upper Limb Assessment (RULA) and Strain Index (SI). Additionally, they filled out the Nordic body map questionnaire. Finally, the equipment and environmental conditions of the operation rooms were also evaluated. The data were analyzed using Excel and SPSS software. The highest MSD prevalence rate was related to the lumber (76.4%) and neck (64.7%). Furthermore, laparoscopic surgery had the upper risk level of MSDs; in this regard, this risk was obtained as 72% and 86% by RULA and SI methods, respectively. Furthermore, among the laparoscopic surgeries, neck posture risk level was significantly different from that of the open surgeries in the RULA approach (P<0.05). Likewise, in the SI method, the risk level of the wrist in laparoscopic surgeries was significantly different from that of the open surgeries (P<0.05). As the findings of the present study indicated, the risk level of laparoscopic operation was higher than that of the open surgeries. However, much non-compliance in terms of the surgeons and non-ergonomic equipment was observed with ergonomic instructions in both of the mentioned operations. Therefore, it is suggested to adopt ergonomic corrective measures with the priority of laparoscopic surgeries in order to prevent MSDs among surgeons.