Department of Medical and Surgical Gynecology, Mayo Clinic, Phoenix, Arizona, USA.
Curr Opin Obstet Gynecol. 2024 Aug 1;36(4):260-265. doi: 10.1097/GCO.0000000000000968. Epub 2024 May 21.
Surgeons are rapidly diversifying as a population, introducing new ergonomic challenges. This review describes the challenges that are experienced by special populations of surgeons including small-handed surgeons, pregnant surgeons, and trainees, and evidence-based solutions to overcome them.
Small-handed and female surgeons report more musculoskeletal complaints compared with their male counterparts. Pregnant surgeons frequently report development or worsening of musculoskeletal disorders such as carpal tunnel syndrome and low back pain. Trainees also report high rates of musculoskeletal complaints with minimal autonomy to alter their environment. Limited objective data exists regarding the ideal instruments currently available for special populations. Several small, randomized studies have proposed exercise regimens targeting the upper extremities and pregnancy-related pain syndromes with improvements in symptoms. Various methods of ergonomic education have been studied in trainees with improvements in operating room posture and performance.
Limited objective data is available to recommend specific surgical instruments for high-risk surgeon populations. Beneficial exercise regimens have been described for musculoskeletal disorders commonly plaguing surgeons but have yet to be studied explicitly in small-handed or pregnant surgeons and trainees.
外科医生群体正在迅速多样化,这带来了新的人体工程学挑战。本综述描述了特殊人群(包括手小的外科医生、孕妇外科医生和外科住院医师)所面临的挑战,以及克服这些挑战的循证解决方案。
手小的和女性外科医生比男性同行报告更多的肌肉骨骼投诉。孕妇外科医生经常报告出现或恶化肌肉骨骼疾病,如腕管综合征和下腰痛。住院医师也报告了很高的肌肉骨骼投诉率,但他们几乎没有自主权来改变他们的环境。目前针对特殊人群,关于理想器械的客观数据有限。一些小型随机研究提出了针对上肢和妊娠相关疼痛综合征的锻炼方案,这些方案改善了症状。在住院医师中,已经研究了各种人体工程学教育方法,这些方法改善了手术室的姿势和表现。
目前可用的客观数据有限,无法为高风险外科医生人群推荐特定的手术器械。针对常见困扰外科医生的肌肉骨骼疾病,已经描述了有益的锻炼方案,但在手小或孕妇外科医生和住院医师中尚未进行专门研究。