Department of Orthopaedics and Sports Medicine and University of Washington School of Medicine, Seattle, Washington, USA.
Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA.
J Endourol. 2021 Nov;35(11):1710-1715. doi: 10.1089/end.2021.0260. Epub 2021 Sep 17.
Chronic neck pain is the most prevalent work-related musculoskeletal injury among surgeons. Urologists may be at higher risk of neck injury due to extended time spent operating in deep anatomical structures during open surgery. Our goal was to use wearable technology to quantify the relationship between neck posture and pain during open and robotic surgery. Urologic attendings and residents who spent at least 1 day per week performing surgery for >6 hours took part in this study. Neck posture was measured in real time during surgery using inertial measurement devices attached at the occipital protuberance and seventh cervical vertebrae. Self-reported neck pain scores were obtained throughout their workday. Thirty participants and 202 hours of surgery were included in the study (21 attendings, 9 residents). There was a significant association between neck posture and pain ( = 0.04). Surgeons performing open procedures spent on average 147 minutes with their head in neck flexion postures of 30° or greater compared with 68 minutes for those performing robotic procedures ( = 0.007). Surgeons performing open procedures reported a mean change in neck pain of 2.0 on the numeric analogue scale, compared with 1.3 for those performing robotic procedures ( = 0.04). Real-time measurements of neck flexion during urologic surgery shows that greater duration and higher degree of neck flexion were associated with increased neck pain. Raising awareness about ergonomics in the operating room during residency will enable future generations of surgeons to make conscious decisions regarding their neck posture in surgery.
慢性颈部疼痛是外科医生中最常见的与工作相关的肌肉骨骼损伤。由于在开放手术中长时间在深部解剖结构中操作，泌尿科医生颈部受伤的风险可能更高。我们的目标是使用可穿戴技术来量化开放和机器人手术中颈部姿势与疼痛之间的关系。至少每周有 1 天进行 >6 小时手术的泌尿科主治医生和住院医师参加了这项研究。使用贴在枕骨隆突和第七颈椎上的惯性测量装置实时测量手术中的颈部姿势。在整个工作日内获得自我报告的颈部疼痛评分。 该研究包括 30 名参与者和 202 小时的手术（21 名主治医生，9 名住院医师）。颈部姿势与疼痛之间存在显著相关性（ = 0.04）。与进行机器人手术的医生相比，进行开放手术的医生在 30°或更大的颈部前屈姿势下，其头部平均花费 147 分钟，而进行机器人手术的医生则花费 68 分钟（ = 0.007）。进行开放手术的医生报告颈部疼痛的平均变化为 2.0，而进行机器人手术的医生为 1.3（ = 0.04）。 泌尿科手术中颈部前屈的实时测量表明，颈部前屈时间更长和角度更大与颈部疼痛增加有关。在住院医师阶段提高手术室人体工程学意识将使未来几代外科医生能够在手术中对自己的颈部姿势做出有意识的决定。
