Surgical ergonomics: Assessment of surgeon posture and impact of training device during otolaryngology procedures

Objective To identify factors associated with cervical-thoracic spine posture in otolaryngology surgeries and evaluate the efficacy of a commercially available posture-training device in enhancing surgeon ergonomics. Methods Over 3 months, neck and spine posture from individuals performing otolaryngology surgeries was recorded using UpRight Go 2 (TM). Average baseline posture was first recorded and biofeedback was later introduced to attempt to correct posture. The proportion of time spent in upright/neutral cervical-thoracic spine posture was correlated with surgeon and procedure characteristics and compared to proportion of upright posture time after biofeedback intervention. Results The proportion of upright operating time was significantly different between procedure subtypes and surgical approaches with best performance in rhinology procedures and worst performance in head and neck surgeries (90% vs. 62%; both p < .001). Female gender, shorter stature, and use of sitting stools were associated with greater proportion of surgery spent upright (all p < .05). Loupes use was associated with less time in upright posture (p < .001). With biofeedback intervention, 8 of 10 subjects demonstrated an average of 5% improvement in operating upright, with most improvement found when performing laryngology procedures (7%) and least improvement in head and neck procedures (2%). Conclusions While surgeon posture varies across otolaryngology surgeries, sitting and minimizing the use of loupes may help promote a more ergonomic operating environment and improve surgeon posture. Although the efficacy of biofeedback intervention from a commercially available posture-training device differs among otolaryngologists, exploration of alternative interventions and incorporation of an ergonomics curriculum is warranted to address postural issues experienced by many surgeons. Level of Evidence 3.

Automated summary

This study aimed to identify factors associated with cervical-thoracic spine posture in otolaryngology surgeries and evaluate the effectiveness of a commercially available posture-training device in improving surgeon ergonomics. The study found that the proportion of upright operating time varied significantly depending on the procedure subtype and surgical approach. Female gender, shorter stature, and use of sitting stools were associated with more upright posture, while the use of loupes was associated with less time spent in upright posture. With the introduction of biofeedback intervention, most subjects showed improvement in operating upright, with laryngology procedures showing the most improvement and head and neck procedures showing the least improvement. The study concludes that sitting and minimizing the use of loupes can promote a more ergonomic operating environment and suggests exploring alternative interventions and incorporating ergonomics curriculum to address postural issues experienced by surgeons.