Bariatric Times

MAR 2018

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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Original Research 19 Bariatric Times • March 2018 However, according to our results, male participants tended to exhibit more pain during laparoscopic bariatric procedures in their wrists and fingers compared to female participants (17.6% and 18.0% vs. 11.8% and 5.9%, respectively), but vice versa when it came to neck and shoulder complaints (15.8% and 23.9% vs. 23.5% and 35.3%, respectively). This finding could be influenced by the anatomical muscular differences between the sexes, as well as the differences between working life and private circumstances. 26 Physical complains might be thought of as "part of the job;" however, when such complaints appear to influence the quality of surgical care, it becomes a matter of concern. As was shown by our study, 27.2 percent of the surgeons felt that the pain they had experienced had caused them to decrease their caseload, with 29.4 percent of the surgeons reporting that this pain affected their task accuracy/surgical performance. Multiple studies illustrated the same finding, with surgeons believing that their surgical performance was negatively affected by their own injury or pain. 27–29 This observation is of concern and raises the question as to what should be done to decrease these modifiable factors. The limitations of our study include the use of self-reported measures to assess the degree of pain, as well as recall bias, as the disorders were surgeon-reported injuries. However, while subjective reports are not alone diagnostic of musculoskeletal pathology, subjective complaints remain the most common manifestation of musculoskeletal occupational injury. CONCLUSION MSK injuries and pain are a common occurrence among the population of bariatric surgeons, and have the ability to hinder performance at work, decreasing case loads and performance. Therefore, it is important to investigate ways to improve ergonomics for these surgeons to improve quality of life. From our results, we could see that the French position was a cause of back pain, while lack of exercise was correlated to neck and back issues. REFERENCES 1. Karahan A, Kav S, Abbasoglu A, Dogan N. Low back pain: prevalence and associated risk factors among hospital staff. J Adv Nurs. 2009;65:516–24. 2. United States: Department of labour; 2005. Labour statistics Workplace injuries and illnesses in 2005. 3. "Estimate of Bariatric Surgery Numbers, 2011-2015." American Society for Metabolic and Bariatric Surgery. N.p., n.d. Web. 01 Aug. 2017. 4. Franasiak J, Ko EM, Kidd J, et al. Physical strain and urgent need for ergonomic training among gynecologic oncologists who perform minimally invasive surgery. Gynecol Oncol. 2012;126:437–442. 5. Park A, Lee G, Seagull FJ, et al. Patients benefit while surgeons suffer: an impending epidemic. J Am Coll Surg. 2010;210:306–313. 6. Sari V, Nieboer TE, Vierhout ME, et al. The operation room as a hostile environment for surgeons: physical complaints during and after laparoscopy. Minim Invasive Ther Allied Technol. 2010;19:105–109. 7. Sodergren MH, Aslanyan A, McGregor CG, et al. Pain, well- being, body image and cosmesis: a comparison of single-port and four-port laparoscopic cholecystectomy. Minim Invasive Ther Allied Technol. 2014;23:223–229. 8. Autorino R, Stein RJ, Lima E, et al. Current status and future perspectives in laparoendoscopic single-site and natural orifice transluminal endoscopic urological surgery. Int J Urol. 2010;17:410–431. 9. Lee G, Sutton E, Clanton T, et al. Higher physical workload risks with NOTES versus laparoscopy: a quantitative ergonomic assessment. Surg Endosc. 2011;25:1585–1593. 10. Alleblas CC, Velthuis S, Nieboer TE, et al. The physical workload of surgeons: a comparison of SILS and conventional laparoscopy. Surg Innov. 2015;22:376–381. 11. Koca D, Yildiz S, Soyupek F, et al. Physical and mental workload in singleincision laparoscopic surgery and conventional laparoscopy. Surg Innov. 2015;22:294–302. 12. Zihni AM, Ohu I, Cavallo JA, et al. Ergonomic analysis of robot-assisted and traditional laparoscopic procedures. Surg Endosc. 2014;28:3379–3384. 13. Lawson EH, Curet MJ, Sanchez BR, et al. Postural ergonomics during robotic and laparoscopic gastric bypass surgery: a pilot project. J Robot Surg. 2007;1:61– 67. 14. Luxembourg: European Communities; 2004. European Communities Work and health in the EU, a statistical portrait. 15. Kuorinka I, Jonsson B, Kilbom A, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233–237 16. Lester JD, Hsu S, Ahmad CS. Occupational hazards facing orthopedic surgeons. Am J Orthop. 2012;41(3):132–139. 17. Mirbod SM, Yoshida H, Miyamoto K, et al. Subjective complaints in orthopedists and general surgeons. Int Arch Occup Environ Health. 1995;67(3):179– 186. 18. Auerbach JD, Weidner ZD, Milby AH, et al. Musculoskeletal disorders among spine surgeons: results of a survey of the Scoliosis Research Society membership. Spine. 2011;36(26):1715–1721. 19. Alleblas, Chantal C. J., Anne Marie De Man, Lukas Van Den Haak, Mark E. Vierhout, Frank Willem Jansen, and Theodoor E. Nieboer. "Prevalence of Musculoskeletal Disorders Among Surgeons Performing Minimally Invasive Surgery." Annals of Surgery (2017): 1. Web. 20. Kolfschoten NE, van Leersum NJ, Gooiker GA, et al. Successful and safe introduction of laparoscopic colorectal cancer surgery in Dutch hospitals. Ann Surg. 2013;257:916–921. 21. Keus F, de Jong JA, Gooszen HG, et al. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev. 2006;4:CD006231. 22. Sauerland S, Jaschinski T, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2010;10:CD001546. 23. Plerhoples TA, Hernandez- Boussard T, Wren SM. The aching surgeon: a survey of physical discomfort and symptoms following open, laparoscopic and robotic surgery. J Robot Surg. 2012;6:65–72. 24. Santos-Carreras L, Hagen M, Gassert R, et al. Survey on surgical instrument handle design: ergonomics and acceptance. Surg Innov. 2012;19:50–59. 25. Giberti C, Gallo F, Francini L, et al. Musculoskeletal disorders among robotic surgeons: a questionnaire analysis. Arch Ital Urol Androl. 2014;86:95–98. 26. Krantz G, Berntsson L, Lundberg U. Total workload, work stress and perceived symptoms in Swedish male and female white- collar employees. Eur J Public Health. 2005;15:209–214. 27. Adams SR, Hacker MR, McKinney JL, et al. Musculoskeletal pain in gynecologic surgeons. J Minim Invasive Gynecol. 2013;20: 656–660. 28. Ruitenburg MM, Frings-Dresen MH, Sluiter JK. Physical job demands and related health complaints among surgeons. Int Arch Occup Environ Health. 2013;86:271–279. 29. Esposito C, Najmaldin A, Schier F, et al. Work-related upper limb musculoskeletal disorders in pediatric minimally invasive surgery: a multicentric survey comparing laparoscopic and sils ergonomy. Pediatr Surg Int. 2014;30:395–399. FUNDING: No funding was provided for this article. DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article. AUTHOR AFFILIATION: Drs. Al-Sabah, Al Haddad, and Khwaja are with the Al-Amiri Hospital in Kuwait. ADDRESS FOR CORRESPONDENCE: Salman Al-Sabah, MD, MBA, FRCSC, FACS; Email: salman.k.alsabah@gmail. com. BT Physical complaints might be thought of as "part of the job;" however, when such complaints appear to influence the quality of surgical care, it becomes a matter of concern. Call for Case Reports! Do you have a case that illustrates a new, unique, or innovative treatment method? Bariatric Times is seeking submissions! Case reports are short presentations of cases that stimulate research and the exchange of information, and illustrate new, unique, and/or innovative treatment methods or perspectives on the signs and symptoms, diagnosis, and treatment of a disorder. To submit a case report, contact: Angela Saba, Managing Editor, Matrix Medical Communications Email:

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