title: Occupational hazards of endoscopic surgery.
abstract: BACKGROUND
  Minimally invasive surgery has taken its toll on the physical well-being of surgeons. There have been many physical consequences for surgeons. However, few have been investigated, specifically for otolaryngologists performing endoscopic endonasal surgery (EES). The purpose of this study is to define the prevalence, quality, and severity of physical symptoms that otolaryngologists experience as they relate to the surgeons' use of ergonomically designed endoscopic instruments in endonasal surgery.
  
  
  METHODS
  A 25-question survey was administered between September 2010 and March 2011 to practicing otolaryngologists. The questions addressed demographics, physical symptoms, ergonomics, and operating room environment. Data were analyzed using Fisher's exact, Wilcoxon rank sum, and Jonckheere-Terpstra statistics.
  
  
  RESULTS
  Sixty-two surgeons responded with a median age of 36 years. Responders performed a median of 150 EESs per year and 37% had completed an endoscopic fellowship. The majority (77%) of responders had experienced physical discomfort or symptoms that they attributed to EES. Thirteen percent (13%) of those who had experienced symptoms felt that their symptoms were persistent. Only 23% of those experiencing symptoms had sought medical care. No significant associations were seen between surgeon age, number of cases, standing, or having adjustable video display with experiencing discomfort (all p > 0.49). Interestingly, fewer surgeons completing an endoscopic fellowship experienced discomfort (70% vs 82%, p = 0.35).
  
  
  CONCLUSIONS
  Our data showed that 77% of physicians who regularly perform EES suffer physical discomfort or symptoms attributable to EES. As expanded endonasal procedures become more prevalent, additional data and ergonomic analysis are necessary to reverse this trend and reduce possible long-term damage for surgeons.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Little
authors.forename: Allison M
authors.initials: AM
authors.lastname: Deal
authors.forename: Adam M
authors.initials: AM
authors.lastname: Zanation
authors.forename: Kibwei
authors.initials: K
authors.lastname: McKinney
authors.forename: Brent A
authors.initials: BA
authors.lastname: Senior
authors.forename: Charles S
authors.initials: CS
authors.lastname: Ebert
mesh_terms: D000328:Adult; D004724:Endoscopy / Q000009:adverse effects*; D006804:Ergonomics; D005260:Female; D007839:Functional Laterality; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D009873:Operating Rooms; D010036:Otolaryngology; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects*; D013523:Surgical Equipment; D011795:Surveys and Questionnaires