title: Ergonomics in office-based surgery: a survey-guided observational study.
abstract: BACKGROUND
  The practice of office-based surgery is increasing in many specialties.
  
  
  OBJECTIVE
  Using Mohs surgery as a model, we investigated the role of ergonomics in office-based surgery to limit work-related musculoskeletal disorders.
  
  
  METHODS
  All Mayo Clinic surgeons currently performing Mohs surgery and Mohs surgeons trained at Mayo Clinic between 1990 and 2004 received a questionnaire survey between May 2003 and September 2004. A sample of respondents were videotaped during surgery. The main outcome measures were survey responses and an ergonomist's identification of potential causes of musculoskeletal disorders.
  
  
  RESULTS
  All 17 surgeons surveyed responded. Those surveyed spend a mean of 24 hours per week in surgery. Sixteen said they had symptoms caused by or made worse by performing surgery. Symptom onset occurred on average at age 35.4 years. The most common complaints were pain and stiffness in the neck, shoulders, and lower back and headaches. Videotapes of 6 surgeons revealed problems with operating room setup, awkward posture, forceful exertion, poor positioning, lighting, and duration of procedures.
  
  
  CONCLUSIONS
  Symptoms of musculoskeletal injuries are common and may begin early in a physician's career. Modifying footwear, flooring, table height, operating position, lighting, and surgical instruments may improve the ergonomics of office-based surgery.
authors.affiliation: Department of Dermatology, Mayo Clinic, Jacksonville, Florida, USA.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Esser
authors.forename: James G
authors.initials: JG
authors.lastname: Koshy
authors.forename: Henry W
authors.initials: HW
authors.lastname: Randle
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D001248:Asthenopia / Q000517:prevention & control; D004487:Edema / Q000517:prevention & control; D006804:Ergonomics / Q000379:methods*; D005260:Female; D006261:Headache / Q000517:prevention & control*; D006801:Humans; D017116:Low Back Pain / Q000517:prevention & control; D008297:Male; D008910:Minnesota; D015580:Mohs Surgery / Q000379:methods*; D009140:Musculoskeletal Diseases / Q000517:prevention & control*; D019547:Neck Pain / Q000517:prevention & control; D009784:Occupational Diseases / Q000517:prevention & control*; D010820:Physicians; D010824:Physicians' Offices; D011159:Population Surveillance; D011187:Posture; D020069:Shoulder Pain / Q000517:prevention & control; D014743:Videotape Recording