A qualitative analysis of the significance of ergonomics among vascular surgeons

Objective

Surgical ergonomics has become an increasingly recognized topic of discussion in surgical literature. Vascular surgery is a high-stress field with long operating hours, which can become physically challenging for surgeons. The study aims to investigate the ergonomic challenges experienced by vascular surgeons and identify current habits and rituals used for optimal ergonomics.

Methods

The qualitative assessment of vascular surgeons ergonomics was assessed using semistructured interviews. These interviews were conducted with six academic vascular surgeons who often performed open abdominal aortic aneurysm operations at a tertiary care academic medical center. The interview targeted several domains, such as preoperative habits, postoperative habits, and operating room practices. A research team member conducted all interviews, recorded, and later transcribed them. Two independent research team members cross-referenced the interview transcriptions. Thematic analysis using NVivo was performed to identify patterns and themes among the interviews given by the study participants. Differing opinions on the themes were reconciled via discussion between four researchers.

Results

The participants included three female and three male academic vascular surgeons with a mean age of 40 ± 5 years and an average of 6 ± 5 years in practice. In total, five major themes were identified in all six interviews. The themes were perception of ergonomics, preprocedural habits, postprocedural habits, the impact of surgeries on ergonomic health, and advice to future trainees. Within these five themes, there were a multitude of subthemes between the six participants. Of the six participants, two (33%) mentioned the importance of preoperative and postoperative exercise and stretching, including targeting core muscles and legs to cope with the lengthy procedural demands. Some of the comments were alarming and eye opening, for example “Oh, I think it's actually horrible. It's horrible. I know. It's killing me slow.” All six of the participants (100%) emphasized the need for optimizing the height of the surgical table, and four participants (66%) mentioned ensuring the need for proper equipment, such as loupes, during the procedure to prevent neck and back pain postoperatively. Finally, four of the participants (66%) agreed that incoming trainees must develop healthy habits, such as proper sleep hygiene, stretching, and hydration. Three participants (50%) discussed the importance of exercise to overcome the physical demands of vascular surgery and maintaining hobbies during training as coping mechanisms against mental burnout.

Conclusions

Vascular surgeons face unique ergonomic challenges daily. The findings from this qualitative study emphasize the importance of preoperative and postoperative habits, such as regular exercise and manipulation of the height of the surgical table, to help prevent muscular pain postoperatively. Focusing and targeting specific ergonomic factors can help alleviate postoperative mental and physical stress.