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Archive December 2017 XVIII, No. 12

The Aches and Pains of Laparoscopy

Minimally invasive surgery can be a major pain in the neck (and back, shoulders and wrists) for your surgeons.

Dan O

Dan O'Connor, Editor-in-Chief


laparoscopy CONTORTIONIST Laparoscopy can be a painful way for your surgeons to practice, sometimes causing debilitating repetitive stress injuries.

Try holding your shoulders, elbows and wrists like the surgeon in this picture. Awkward, right? After just a few minutes, you'd likely be sore and fatigued. Now imagine holding instruments in that weird, spread-eagle position, gripping and guiding those long chopstick-like tools that don't bend like your wrists and don't move in the same direction as your hand movements — the surgeon's hand moves left, and the instrument tip moves right. To top off our ergonomic exercise, you'll have to crane your neck and squint your eyes to view the procedure on a monitor that's up and over to the right and too far away.

"Do that 3 times a day for 20 years, and you'll really be sore," says Howard Ross, MD, chief of colon and rectal surgery at Temple University Hospital in Philadelphia, Pa. "You think of surgery as a gentle art, but surgeons can be very, very sore by day's end."

Patients love the reduced pain and smaller incisions of minimally invasive surgery, but a day of laparoscopy can be a grueling total body workout for your surgeons. How are your surgeons coping with the physical pain of practicing?

When his pinky and ring finger go numb during a longer case like a colon resection, it feels like your hand fell asleep and you hit your funny bone, says Sean Harbison, MD, a general surgeon at the Hospitals of the University of Pennsylvania-Penn Presbyterian in Philadelphia, Pa. In clinical terms, it's a median or an ulnar neuropraxia from overstressing your wrists. In reality, it's just one of laparoscopy's many aches and pains that can leave your surgeons feeling sore, stiff or worse — pain can incapacitate surgeons, limit their practice or shorten their careers.

"I know several surgeons who had to stop doing surgery because of cervical disc problems," says Dr. Harbison. "They had to change their whole professional trajectory. One became an ICU doctor."

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