Work-related upper limb musculoskeletal disorders in paediatric laparoscopic surgery. A multicenter survey.
BACKGROUND
Surgeons are at risk for developing work-related musculoskeletal symptoms (WMS). The present study aims to examine the physical factors and their association with WMS among pediatric laparoscopic surgeons.


METHODS
A questionnaire consisting of 21 questions was created and mailed to 25 pediatric laparoscopic surgeons (LG). 23/25 surgeons (92%) completed the survey. The questionnaire was analyzed and then split into 2 groups. Group 1 (LG1) included surgeons with greater laparoscopic experience, and group 2 (LG2) included surgeons with less important laparoscopic experience. In addition, we constructed and sent to the same surgeons a similar questionnaire focused on WMS after an open procedure (OG) with the aim to compare results of LG with OG.


RESULTS
The prevalence rate of WMS with shoulder symptoms was 78.2% in surgeons that performed laparoscopy for more than 10 years, with 60.8% also reporting other pain. In 66.6% this pain is evident only after a long-lasting procedure. Forty-four percent of these surgeons require painkillers at least twice a week. Fifty percent of these surgeons also suffer at home. Fifty-five and one half percent of surgeons indicate that this pain is related to their laparoscopic activity. Forty-three and a half percent think that laparoscopy is beneficial only for the patient but has a bad ergonomic effect for surgeons. Sixty-five and two-tenths percent think that robotic surgery can be helpful to improve ergonomics. Comparing the groups, WMS occur more frequently in LG (78.2%) than in OG (56.5%), but this difference was not statistically significant (χ(2)=0.05). In addition, WMS occur more frequently in LG1 (84.6%) than in LG2 (70%), but this difference was not statistically significant (χ(2)=0.05).


CONCLUSIONS
These results confirmed a strong association between WMS and the number of laparoscopic procedures performed. Skilled laparoscopic surgeons have more pain than less skilled laparoscopic surgeons. WMS in the same group of surgeons are more frequent after laparoscopy than after open procedures. The majority of surgeons refer to shoulder symptoms.
Pediatric Surgery Units, Federico II University Naples, Italy. ciroespo@unina.it
Ciro
C
Esposito
Alaa
A
El Ghoneimi
Atsuyuki
A
Yamataka
Steve
S
Rothenberg
Marcela
M
Bailez
Marcelo
M
Ferro
Piergiorgio
P
Gamba
Marco
M
Castagnetti
Girolamo
G
Mattioli
Pascale
P
Delagausie
Dimitris
D
Antoniou
Philippe
P
Montupet
Antonio
A
Marte
Amulya
A
Saxena
Mirko
M
Bertozzi
Paul
P
Philippe
François
F
Varlet
Hubert
H
Lardy
Antony
A
Caldamone
Alessandro
A
Settimi
Gloria
G
Pelizzo
Francois
F
Becmeur
Maria
M
Escolino
Teresa
T
De Pascale
Azad
A
Najmaldin
Felix
F
Schier
D001134:Arm Injuries / Q000453:epidemiology* / Q000209:etiology; D012090:Cumulative Trauma Disorders / Q000453:epidemiology* / Q000209:etiology; D003625:Data Collection; D006804:Ergonomics; D006801:Humans; D010535:Laparoscopy; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D010372:Pediatrics; D012189:Retrospective Studies; D020069:Shoulder Pain / Q000453:epidemiology / Q000209:etiology; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology; D013043:Specialties, Surgical; D011795:Surveys and Questionnaires; D013997:Time Factors; D020535:Video-Assisted Surgery; D016526:Workload
Ergonomics; Laparoscopy; Shoulder pain; Work-related musculoskeletal symptoms