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Surgeon burnout is another potential ramification of workplace injury. Overall
surgeon burnout is reported to be around 40% [ 60 , 61 ]. A relationship between pain
and burnout has been established in nurses [ 62 ] and may also be present in sur-
geons. Self-reported burnout has been found to positively correlate to increased
pain, with burned-out vascular surgeons reporting more pain both during and after
operating [ 48 ].
Risk Factors for Surgeon Injury
Identification of risk factors predisposing surgeons to occupational injury is the first
step toward an ergonomic solution. Many risk factors correlate with the surgical
modality and equipment used. Non-modifiable risk factors such as gender, hand
size, and height are important to understand as they may be addressed with proper
ergonomic adjustment. Additionally, both lack of surgical experience and poor
ergonomic training are risk factors for injury. The latter can fortunately be mitigated
with ergonomic education during residency.
Surgical Modality
Open Surgery
Overall, open surgery is considered more ergonomic than laparoscopic surgery
because it allows direct visualization, greater range of motion, less confined
postures, and ease of movement [ 63 , 64 ]. For this reason, the ergonomics of open
surgery have not been as well researched as minimally invasive surgery (MIS)
[ 8 , 63 , 65 ]. There are, however, unique ergonomic challenges during open
procedures. Specifically, surgeons spend up to 54% of the time with their head bent
forward (see surgeon on the right in Fig. 22.1) and 27% of the time spent with their
Fig. 22.1 The surgeon on
the left is standing with
correct posture with her
head at a slight inclination
of approximately 20°. The
surgeon on the right has
incorrect posture with his
back and head extremely
flexed
C. Ronstrom et al.