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Ergonomics for surgeons

Author's details

  • Dr. Khashau Eleburuike.
  • MBBS (Ilorin), MSc. Global Health Karolinska Institute Sweden
  • Resident doctor in family medicine in the northern region of Sweden.

Reviewer's details

  • Dr Victor Ameh
  • MBBS, MA (Law & Ethics), FRCSEd, FRCEM, FEWI, MCMI Consultant in Emergency Medicine (A&E).
  • The Royal Albert Edward Infirmary, WWL Teaching Hospitals NHS Foundation Trust, Wigan Lane, Wigan, WN1 2NN, Greater Manchester. Hon. Senior Lecturer, University of Manchester Medical School. Hon. Senior Lecturer, Mch/MMed Programme, Edge Hill University.

Ergonomics for surgeons

Introduction

Ergonomics, the science of designing work environments to fit the physical capabilities of the workers, is crucial in healthcare, particularly for surgeons. In sub-Saharan Africa, where healthcare systems often face resource limitations, the importance of ergonomics in surgical settings is often overlooked. However, neglecting ergonomic principles can lead to significant health issues for surgeons and affect the quality of care provided to patients.

Discussion
Challenges in Sub-Saharan Africa

1. Resource Constraints: Hospitals and clinics in sub-Saharan Africa often operate with limited resources, including outdated or inappropriate equipment. This can force surgeons to adopt awkward postures or exert excessive force during procedures, leading to musculoskeletal disorders (MSDs) such as back pain, neck strain, and repetitive stress injuries.

2. Infrastructure Limitations: Operating rooms (ORs) in many regions may not be designed with ergonomics in mind. Poor lighting, insufficient space, and non-adjustable surgical tables or chairs are common issues. These factors can contribute to visual strain, awkward positioning, and increased fatigue during long surgeries.

3. Workload and Staffing: High patient volumes and a shortage of trained medical staff mean that surgeons in sub-Saharan Africa often work long hours without adequate rest. Prolonged standing, repetitive movements, and mental stress increase the risk of ergonomic-related injuries.

4. Lack of Awareness and Training: Ergonomic training is not always a standard part of medical education in the region. Surgeons and other medical staff may not be aware of the importance of ergonomics or how to apply ergonomic principles in their daily work.

 

Ergonomic Solutions and Recommendations

1. Improving OR Design and Equipment: Investing in adjustable surgical tables, ergonomic chairs, and better lighting can significantly reduce the risk of MSDs among surgeons. While funding may be limited, prioritizing these improvements in new facilities or through donations could have a long-term positive impact on surgeon health and patient outcomes.

2. Adopting Ergonomic Practices:

- Proper Positioning: Surgeons should maintain a neutral spine position, keeping the head, neck, and shoulders aligned. Elevating patients or using footrests can help reduce strain.

- Instrument Design: Using lightweight, well-balanced surgical instruments that require minimal force can reduce hand and wrist strain.

- Visual Ergonomics: Enhancing lighting in the OR and using magnification tools like loupes can reduce eye strain and improve precision.

3. Training and Education: Integrating ergonomic principles into surgical training programs is essential. Workshops, seminars, and continuing medical education (CME) courses focusing on ergonomics can increase awareness and encourage best practices.

4. Workload Management: Hospitals should strive to manage workloads by hiring more staff, optimizing schedules to include adequate rest periods, and rotating tasks to minimize repetitive strain on surgeons. Encouraging teamwork and delegation of tasks can also reduce the burden on individual surgeons.

5. Policy and Advocacy: Governments, medical associations, and NGOs should advocate for better ergonomic standards in healthcare. This includes pushing for investments in infrastructure and equipment, as well as incorporating ergonomics into health and safety regulations for medical professionals.

Conclusion

Ergonomics is a critical yet often neglected aspect of surgical practice in sub-Saharan Africa. By addressing ergonomic challenges, healthcare systems in the region can not only protect the health and well-being of surgeons but also improve the quality of care provided to patients. Although resource constraints are significant, strategic investments and a focus on education can make a substantial difference in promoting ergonomic practices in the surgical field.

Further readings
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  5. Laura Wilding. How understanding ergonomics can significantly reduce the risk of developing MSDs 20 December 2023. https://www.healthandsafetyinternational.com/article/1851657/navigating-ergonomic-landscape. Accessed August 12 2024.
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  1. Occupational health: health workers. https://www.who.int/news-room/fact-sheets/detail/occupational-health–health-workers. 7 November 2022. Accessed August 12 2024