Our nation’s surgeons are at increased risk of injury because of failure to address ergonomic problems that can ultimately compromise patient outcomes and shorten surgical careers, according to Adrian Park, MD, professor of surgery at Johns Hopkins University School of Medicine, who is presenting on the topic at Digestive Disease Week^® (DDW) 2023.

“This isn’t surgeons whining,” said Dr. Park, who is also the chief surgeon at Luminis Health in Maryland. “The notion of foreshortened surgical careers due to potentially correctable injuries is the last thing that society, health care policymakers and administrators can afford, particularly in light of the well-documented shortage of surgeons and the increased gap between the surgeon workforce and the workload.”

Surgeons assume static positions for extended periods of time, which can lead to injury and fatigue, compromising their attention and stamina. Dr. Park has conducted pioneering work to understand the impact of the surgical environment on surgeon well-being. His work has shown that addressing symptoms can improve attention and mental engagement as well as physical performance.

“Surgeons are resilient. We will stand on our heads to our own detriment to get the best outcome for our patients,” he said, “But we end up assuming unhealthy, static postures with muscles extended for long periods of time, which compromises our stamina and ability to concentrate.”

Dr. Park stressed that while there are high-tech, expensive solutions to improving the surgical workspace, there are also simple, inexpensive solutions that surgeons can implement immediately. Among his recommendations:

Optimize your work environment. Simple changes to the way surgeons stand, place equipment and monitors, and position objects such as the table and pedals, can help them maintain healthier postures and prevent muscle fatigue and injury.

Perform targeted stretching microbreaks. Dr. Park’s research has shown that short stretching breaks (~90 seconds) that target the areas most commonly reported as injured or painful (e.g., the neck, lower back, shoulders, upper back, wrists/hands, knees and ankles) can improve surgeon attention and mental engagement. These stretching breaks can be done at the bedside during a procedure while maintaining sterility.

Participate in research. Research and resources are limited for surgeons hoping to improve workplace ergonomics, but Dr. Park is hopeful that physical well-being is gaining more attention among researchers. A recently established organization, the Society of Surgical Ergonomics, is among those making a concerted effort to better understand the surgical work environment.

“When you look at high-stakes work environments where safety and lives are at stake, there is no environment that is less studied or understood than the perioperative environment,” said Dr. Park. “This is a black hole right now, and careers are to be made in this space.”

Long term, more research is needed to understand and standardize workflow and processes to protect the physical well-being of surgeons and others. Dr. Park encouraged surgeons to participate in research and called for additional funding.

“Young surgeons feel immortal,” he said. “These things don’t really matter until they start accumulating and impact your workday and ultimately your professional longevity and patient care. You need to be proactive. Prevention is so much better than waiting until injuries have occurred.”

Dr. Park’s oral presentation, “Ergonomics and physician wellness” on Sunday May 7, at 4 p.m. CDT is part of the session “SSAT Panel II: Ergonomics and the Surgeon: Striking a Healthier Pose.”