Alumna Karlie Gross
Over the past two years, I've had the privilege to work closely with Meghal Shah, a General Surgery Resident at Columbia University, on a collaborative effort aimed at optimizing surgical workspace ergonomics with the goal of reducing musculoskeletal pain in this population. Suzanne Semanson and Alex Vitrak have played integral roles in this research initiative as well.
Our initial focus was to assess the prevalence of musculoskeletal pain and healthcare utilization among surgical residents and attendings at Columbia University. The survey found that 87.3% of respondents reported pain in the past week, with a substantial percentage requiring further evaluation/treatment in the past including: specialist care, orthopedic surgery, imaging, physical therapy, and medication. This prompted us to delve deeper into optimizing surgical ergonomics and developing strategies to manage musculoskeletal pain in this population.
Our first project concentrated on optimizing loupe fittings, particularly addressing the high prevalence of neck pain among surgeons who use loupes. We fostered an interdisciplinary collaboration involving physical therapist (Suzanne and myself), a loupes sales representative, and surgeons undergoing fittings. The process involved recreating the operating room environment, simulating operating room tasks with an emphasis on educating on basic ergonomic principles, and ensuring proper setup with the surgeon in an upright posture, at appropriate working table height, and at optimal distance to the surgical field prior to the loupe fitting.
The subsequent project involved creating a set of exercises designed to introduce intraoperative microbreaks in the operating room, with the goal of reducing musculoskeletal pain and fatigue. These microbreaks, included six different movement patterns lasting 60 seconds total, aimed at mitigating prolonged static standing postures. Implementation involved providing an educational video demonstrating/verbalizing the exercises, placing posters in the operating room, and live demonstrations.
In collaboration, we developed and implemented a surgical ergonomics workshop for surgical residents, covering topics such as posture/postural stacking, optimizing body mechanics during bedside tasks and surgical retraction, and workspace ergonomics tailored to various operating room environments, including open/laparoscopic procedures and robotic settings with specific ergonomic considerations for sitting.
Presently, our focus is on investigating the potential benefits of utilizing postural devices, such as the Upright GO 2, to provide real-time vibratory feedback to optimize intraoperative posture and reduce the amount of time spent in cervical flexion, contributing to ongoing efforts to decrease the prevalence of musculoskeletal pain in this population.
For further information:
- Shah M, Gross K, Wang C, Kurlansky P, Krishnamoorthy S. Working through the pain: a cross-sectional survey on musculoskeletal pain among surgeons and residents. J Surg Res. 2024;293:335-240.
- Shah M, Gross K, Pentico M, Sathe TS, Semanson S. Loupe better: a guide for an ergonomic loupe training program. Am J Surg. 2023;226:747-750.