Human factors evaluation of surgeons’ working positions for gynecologic minimal access surgery

Study Objective: To investigate work-related musculoskeletal disorders (WRMSD) in gynaecological minimal access surgery (MAS), including bariatric (plus size) patients. Design: Mixed methods Design classification: Level III (descriptive and qualitative) Setting: UK Teaching Hospital Patients: Not applicable Interventions: Not applicable Measurements: Survey, observations (anthropometry, postural analysis) and interviews. Results: WRMSD were present in 63% of survey respondents (n=67). The pilot study (n=11) identified contributory factors including workplace layout, equipment design and preference of port use (relative to patient size). Statistically significant differences for WRMSD-related posture risks were found within groups (average size mannequin and plus size mannequin) but not between patient size groups suggesting that port preference may be driven by surgeon preference (and experience) rather than patient size. Conclusion: Some of the challenges identified in this project need new engineering solutions to allow flexibility to support surgeon choice of operating approach (open, laparoscopic or robotic) with a work place which supports adaptation to the task, surgeon and patient.