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Sitting versus standing makes a difference in musculoskeletal discomfort and postural load for surgeons performing vaginal surgery

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Abstract

Introduction and hypothesis

We compared musculoskeletal discomfort and postural load among surgeons in sitting and standing positions during vaginal surgery.

Materials and methods

Assessment of discomfort and posture of the primary surgeons in both positions was performed at two institutions. The primary outcome was an increase in body discomfort score after surgery as determined from subjective responses using validated tools. The secondary outcome was the percentage of time spent in awkward body postures measured objectively and stratified into awkward postures for neck, trunk, and bilateral shoulder angles. Variables were compared between sitting and standing positions using Fisher’s exact test for primary outcomes and Wilcoxon rank-sum test for secondary outcomes.

Results

Data were collected for 24 surgeries from four surgeons in sitting position and nine surgeries from nine surgeons in standing position. The standing surgeons reported a significant increase in discomfort postoperatively for bilateral wrists, thighs, and lower legs compared with the sitting surgeons. The median percentage of time spent in awkward postures was significantly lower for the trunk in the standing versus sitting position (median 0.3% vs 58.8%, p < 0.001) but was significantly higher for both shoulders in the standing versus the sitting position (right shoulder: median 17.8% vs 0.3%, p = 0.003; left shoulder: median 7.4% vs 0.2%, p = 0.003).

Conclusion

Surgeons reported more discomfort in when performing vaginal surgery while standing. The postural load was worse for trunk but favorable for bilateral shoulders when seated. Such differences may impact a surgeon’s decision to perform vaginal surgery seated rather than standing.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Florida, 653-1 W. 8th Street, Jacksonville, FL, 32209, USA

    Ruchira Singh

  2. Department of Obstetrics and Gynecology, Columbia University New York Presbyterian, New York, NY, USA

    Ladin A. Yurteri-Kaplan

  3. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

    Melissa M. Morrow, Amy L. Weaver, Michaela E. McGree & Susan Hallbeck

  4. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA

    Melissa M. Morrow & Susan Hallbeck

  5. School of Mechanical, Industrial, and Manufacturing Engineering, Oregon State University, Corvallis, OR, USA

    Xinhui Zhu

  6. Department of Industrial and Systems Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA

    Victor L. Paquet

  7. Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA

    John B. Gebhart

Authors
  1. Ruchira Singh
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  2. Ladin A. Yurteri-Kaplan
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  3. Melissa M. Morrow
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  6. Xinhui Zhu
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  9. Susan Hallbeck
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Corresponding author

Correspondence to Ruchira Singh.

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Conflicts of interest

Ruchira Singh: None.

Ladin A. Yurteri-Kaplan: None.

Melissa M. Morrow: None.

Michaela E. McGree: None.

Amy L. Weaver: None.

Xinhui Zhu: None.

Victor L. Paquet: None.

John B. Gebhart: Royalties - UpToDate and Elsevier.

Susan Hallbeck: None.

Paper presentation

Accepted for oral poster presentation at the 43rd Annual Scientific Meeting of the Society of Gynecologic Surgeons, 26–29 March 2017, San Antonio, TX, USA.

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Singh, R., Yurteri-Kaplan, L.A., Morrow, M.M. et al. Sitting versus standing makes a difference in musculoskeletal discomfort and postural load for surgeons performing vaginal surgery. Int Urogynecol J 30, 231–237 (2019). https://doi.org/10.1007/s00192-018-3619-1

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  • DOI: https://doi.org/10.1007/s00192-018-3619-1

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