sign , an accelerated biomedical innovation program housed under the University of Louisville School of Medicine , we partnered with undergraduate engineering students from the J . B . Speed School of Engineering to design a new surgical stool . Through a phased approach under faculty guidance , we invented an evidence-based stool prototype to address ergonomics in the operating room and surgeon musculoskeletal health .
Despite advances in medical technology , operating rooms are not designed ergonomically or with the surgeon ’ s health in mind : operating tables have limited mobility , floor surfaces are hard and stools confine the surgeon to a smaller working area . Despite being disliked and unadaptable , current stools are recommended for use when surgeons of different heights are present , “ The table height may be adjusted for the tallest surgeons , and all other surgeons may utilize a lift ( step / stool ) for the best ergonomic setting .” 3 Even so , using a stool prohibits the surgeon from keeping foot pedals used for electrocautery at the same level and removes the ability to use an anti-fatigue mat for enhanced comfort .
So , we thought , “ What if we could design a stool that eliminates the limitations of current technology and mitigates musculoskeletal complaints ?” Our initial prototype focused on the ability to control stool height , minimizing the need for stacking stools . Given that degenerative cervical spine disease is one of the most common clinically diagnosed work-related musculoskeletal disorders among surgeons , 4 our goal was to create a platform designed to minimize neck flexion and reduce head and neck strain . As we continued to optimize our design , we added features to address other common complaints in the OR .
By using a novel approach to biodesign , focusing on surgeon well-being , we recognized that we could simultaneously improve patient care and advocate for our physician colleagues . Enacting change in this space starts with bringing awareness to education in surgical ergonomics . By reducing surgeon work-related musculoskeletal discomfort , we can extend career longevity and reduce surgeon attrition . Ultimately , it is our goal to champion healthier surgeons and staff , and create a more inclusive workforce and operating room .
The Future : Addressing Ergonomics In Surgery and Beyond
Over the past few years , awareness of ergonomics in surgery has been rapidly rising . The Society of Surgical Ergonomics was founded in October 2020 to address the professional needs of surgeons and proceduralists in their interactions with their procedural environments to improve their well-being , quality of life and career longevity . The Society facilitates scientific dialogue , education and innovation related to surgical ergonomics . In December 2021 , the American College of Surgeons ( ACS ) made a formal statement on surgeon well-being and committed to promoting research and education that enhances programs , interventions and strategies that integrate well-being into all facets of a surgeon ’ s career . Subsequently , the ACS Division of Education Surgical Ergonomics Committee was formed to systematically address the ergonomic challenges experienced by surgeons and to improve their well-being . As of 2022 , the ACS hosts an annual Surgical Ergonomics Hands- On Clinic that features simulation stations and offers a hands-on learning experience in surgical ergonomics .
Most recently , the ACS published “ Surgical Ergonomic Recommendations ” ( 2023 ) to address the full spectrum of surgeon-related ergonomic issues in the operating room and prepare concise best practice recommendations . These guidelines identify known issues , including surgeon posture , operating table height , visualization and surgery-related stress , and present intraoperative solutions , solutions before and between cases , and recommendations for long-term prevention and maintenance .
As medical students , we are empowered by the work of national organizations to improve surgeon well-being . But , even before formal guidelines were established , we recognized that guidelines were not always universally applicable . Hence , we proposed a unique solution in a new surgical stool . As recipients of a National Science Foundation grant , we plan to continue advancements with our prototype .
While our project has focused on the surgeon , it is not lost on us that all physicians experience challenges that impact well-being . It is critical for institutional leaders to define a culture that fosters well-being for all : only then will others feel supported in their personal and professional suits and have the physical and mental strength to carry them out .
References :
1
Ksenia AA , Vaughan J , Gupta R , Noor-E-Seher A , Beth AH , Moore JM , Ma Y , Ahmad I , Jackler RK , Vaisbuch Y . The risk of ergonomic injury across surgical specialties . PLoS ONE February 2021 ; 16 ( 2 ): e0244868 .
2
Sutton E , Irvin M , Zeigler C , Lee G , Park A . The ergonomics of women in surgery . Surg Endosc 2014 ; 28 ( 4 ): 1051-1055 .
3
Surgical Ergonomics Recommendations . American College of Surgeons website . Accessed February 10 , 2024 . Available at : https :// www . facs . org / media / tdeemrnw / 23 _ ed _ surgical ergonomicsrecommendations _ pdf _ v4 . pdf .
4
Epstein S , Sparer EH , Tran BN , Ruan QZ , Dennerlein DZ , Singhal D , Lee BT . Prevalence of Work-Related Musculoskeletal Disorders Among Surgeons and Interventionalists : A Systematic Review and Meta-analysis . JAMA Surg . 2018 ; 153 ( 2 ): e174947 .
Whitney Richardson is a third-year medical student at the University of Louisville School of Medicine with plans to attend a residency in urology .
Baylee Polzin is a third-year medical student at the University of Louisville School of Medicine planning to attend a residency in otolaryngology .
Keenya Frazier is a second-year medical student at the University of Louisville School of Medicine .
Onajia Stubblefield is a second-year medical student at the University of Louisville School of Medicine .
April 2024 27