Surgeon Strength: Ergonomics and Strength Training in Cardiothoracic Surgery

The authors review existing literature and propose recommendations to improve physical preparedness for surgery both in and outside the operating room. Cardiothoracic surgeons suffer from MSK pain, most commonly in the neck and back due to a lack of proper ergonomics during surgery. A lack of dedicated ergonomics curriculum during training may leave surgeons at a high predisposition for work-related MSK disorders. The authors reviewed relevant surgical ergonomics studies and prevalence of MSK disease among surgeons and interventionalists. Whenever possible, data from quantitative studies and meta-analyses were presented. They report high rates of work-related pain in surgeons – as high as 87% in minimally-invasive surgeons. Several optimizations regarding correct table height, monitor positioning, and loupe angles are discussed. The authors share factors, including smaller incisions and technological advancements, that led to this plight. They make a case that work-related injuries are underreported and understudied and the field of surgical ergonomics remains open for investigative study. The authors also recommend exercises that can be performed to improve MSK pain and outcomes.