Surgeons' static posture and movement repetitions in open and laparoscopic surgery

J Surg Res. 2012 Jan;172(1):e19-31. doi: 10.1016/j.jss.2011.08.004. Epub 2011 Aug 29.


Background: There is increasing concern about the surgeon maintaining a static posture during laparoscopic surgery, which can contribute to musculoskeletal disorders. A series of studies are being conducted in Hong Kong examining the surgeons' real-time movements and electromyography in the operating theater during different operations. The present paper examines the postures and movements of surgeons during real-time open and laparoscopic procedures.

Materials and methods: Fourteen surgeons participated in the study (12 men, 2 women). Cervical spine movements were measured using a biaxial inclinometer attached to the surgeon's head via a headband. Biaxial electrogoniometers were attached to the surgeon's bilateral shoulder joints. Real-time joint movements in sagittal and coronal planes were recorded during open and laparoscopic surgeries for periods ranging from 30 to 80 min.

Results: Surgeons generally maintained a flexed neck posture during open surgery and a more extended neck posture during laparoscopic procedures. There were statistically significant differences in mean neck posture and mean left shoulder abduction posture between the two types of surgery. Laparoscopic procedures showed a trend for longer duration in static posture in the neck, while open procedures showed trends for higher frequencies of movements.

Conclusions: This study presented a novel approach to quantify the physical workload of surgeons using biomechanical parameters to describe duration of static posture and repetitiveness of movements. Results showed that long durations of static postures in laparoscopic surgery were closely associated with low-level muscle tension, which may contribute to an increased risk of surgeons developing musculoskeletal disorders.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomechanical Phenomena
  • Digestive System Surgical Procedures*
  • Electromyography
  • Female
  • Humans
  • Laparoscopy*
  • Male
  • Movement / physiology*
  • Musculoskeletal Diseases / epidemiology
  • Physicians*
  • Posture / physiology*
  • Risk Factors