TY - JOUR
T1 - Ergonomics in Endoscopic Transsphenoidal Surgery
T2 - A Survey of the North American Skull Base Society
AU - Mattogno, Pier Paolo
AU - Marciano, Filippo
AU - Catalino, Michael P.
AU - Mattavelli, Davide
AU - Cocca, Paola
AU - Lopomo, Nicola Francesco
AU - Nicolai, Piero
AU - Laws, Edward R.
AU - Witterick, Ian
AU - Raza, Shaan M.
AU - Devaiah, Anand K.
AU - Lauretti, Liverana
AU - Olivi, Alessandro
AU - Fontanella, Marco M.
AU - Gentili, Fred
AU - Doglietto, Francesco
N1 - Publisher Copyright:
© 2021. Thieme. All rights reserved.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - Objective: Different surgical set-ups for endoscopic transsphenoidal surgery (ETS) have been described, but studies on their ergonomics are limited. The aim of this article is to describe present trends in the ergonomics of ETS. Design and Participants: A 33-question, web-based survey was sent to North American Skull Base Society members in 2018 and 116 responded to it (16% of all members). Most respondents were from North America (76%), in academic practice (87%), and neurosurgeons (65%); they had more than 5 years of experience in ETS (73%), had received specific training (66%), and performed at least 5 procedures/mo (55%). Results: Mean reported time for standard and complex procedures were 3.7 and 6.3 hours, respectively. The patient's body is usually positioned in a straight, supine position (84%); the head is in a neutral position (46%) or rotated to the side (38%). Most surgeons perform a binostril technique, work with a partner (95%), and operate standing (94%), holding suction (89%) and dissector (83%); sometimes the endoscope is held by the primary surgeon (22-24%). The second surgeon usually holds the endoscope (72%) and irrigation (42%). During tumor removal most surgeons stand on the same side (65-66%). Many respondents report strain at the dorsolumbar (50%) or cervical (26%) level. Almost one-third of surgeons incorporate a pause during surgery to stretch, and approximately half exercise to be fit for surgery; 16% had sought medical attention for ergonomic-related symptoms. Conclusion: Most respondents value ergonomics in ETS. The variability in surgical set-ups and the relatively high report of complaints underline the need for further studies to optimize ergonomics in ETS.
AB - Objective: Different surgical set-ups for endoscopic transsphenoidal surgery (ETS) have been described, but studies on their ergonomics are limited. The aim of this article is to describe present trends in the ergonomics of ETS. Design and Participants: A 33-question, web-based survey was sent to North American Skull Base Society members in 2018 and 116 responded to it (16% of all members). Most respondents were from North America (76%), in academic practice (87%), and neurosurgeons (65%); they had more than 5 years of experience in ETS (73%), had received specific training (66%), and performed at least 5 procedures/mo (55%). Results: Mean reported time for standard and complex procedures were 3.7 and 6.3 hours, respectively. The patient's body is usually positioned in a straight, supine position (84%); the head is in a neutral position (46%) or rotated to the side (38%). Most surgeons perform a binostril technique, work with a partner (95%), and operate standing (94%), holding suction (89%) and dissector (83%); sometimes the endoscope is held by the primary surgeon (22-24%). The second surgeon usually holds the endoscope (72%) and irrigation (42%). During tumor removal most surgeons stand on the same side (65-66%). Many respondents report strain at the dorsolumbar (50%) or cervical (26%) level. Almost one-third of surgeons incorporate a pause during surgery to stretch, and approximately half exercise to be fit for surgery; 16% had sought medical attention for ergonomic-related symptoms. Conclusion: Most respondents value ergonomics in ETS. The variability in surgical set-ups and the relatively high report of complaints underline the need for further studies to optimize ergonomics in ETS.
KW - endoscopic transsphenoidal surgery
KW - ergonomics
KW - operating room set-up
KW - patient position
KW - surgeons
KW - survey
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U2 - 10.1055/s-0041-1729906
DO - 10.1055/s-0041-1729906
M3 - Article
C2 - 35832944
AN - SCOPUS:85106450353
SN - 2193-634X
VL - 83
SP - E380-E385
JO - Journal of Neurological Surgery, Part B: Skull Base
JF - Journal of Neurological Surgery, Part B: Skull Base
ER -