Evidence-based intraoperative microbreak activities for reducing musculoskeletal injuries in the operating room

BACKGROUND: Neuromusculoskeletal pain and fatigue have been self-reported by over 70% surgeons who perform minimally invasive surgery (MIS). These problems can become impairments impacting surgical performance, patient outcomes, and career longevity. Human factors engineering has identified microbreaks coupled with activities as a viable strategy to counteract known physical, cognitive, and environmental stressors as well as mitigate neuromusculoskeletal (NMS) problems for workers in office and manufacturing domains. OBJECTIVE: Develop a novel set of intraoperative surgical microbreaks activities tailored for MIS surgeons to mitigate surgery-induced neuromusculoskeletal fatigue and pain. METHODS: Using NSM problems identified by practitioners and literature, a clinician determined causes and solutions and ranked them based on literature and clinical expertise. Solutions were incorporated into synchronized activities that addressed overarching goals and multiple tissues. RESULTS: The resulting activities, translating contemporary science in clinical physical medicine and rehabilitation practice and tissue biomechanics, specifically address the overarching goals of: 1) posture correction; 2) normalization of tissue tension and soft tissue mobility/gliding; and 3) relaxation/stress reduction. CONCLUSION: Surgeons can perform the activities in approximately one minute inside the sterile field. Movements encompassing multiple requirements and engaging multiple body segments are combined to provide an efficient and effective intervention to the target tissues.