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level [ 125 , 127 ] and with the monitor tilted so that the upper part of the screen is
further back than the lower (Fig. 22.7) [ 72 , 78 ].
In regard to chairs, there are many ergonomically designed office chairs avail-
able. Overall, a chair with lumbar support and adjustable height and inclination is
recommended. The seat should be padded with the front edges curved so that there
is minimal pressure on the popliteal area [ 159 ]. Ideally, seated work is alternated
with standing work [ 112 ]. This can be implemented using a standing desk or a desk
with an adjustable height.
Surgeons may also experience discomfort with using the keyboard and mouse.
Typing and clicking have been associated with multiple musculoskeletal disorders
including carpal tunnel syndrome [ 160 ]. Carpal tunnel pressure increases with
typing when the wrists are in flexion and with mouse use when the wrists are
extended [ 161 – 163 ]. For those surgeons experiencing discomfort with these
Keyboard at
elbow height20 – 50 ̊Fig. 22.7 The center of the computer screen is 20–50° below the eye level and the monitor tilted
so that the upper part of the screen is further back than the lower. The keyboard is at elbow height
and at least 5 inches from the edge of the desk
C. Ronstrom et al.