An ergonomic evaluation of surgeons' axial skeletal and upper extremity movements during laparoscopic and open surgery

Ninh T. Nguyen, Hung S Ho, Warren D. Smith, Constantine Philipps, Clare Lewis, Rodel M. De Vera, Ramon Berguer

Research output: Contribution to journalArticle

131 Scopus citations


Background: Many surgeons have complained of fatigue and musculoskeletal pain after laparoscopic surgery. We evaluated differences in surgeons' axial skeletal and upper extremity movements during laparoscopic and open operations. Methods: Five surgeons were videotaped performing 16 operations (8 laparoscopic and 8 open) to record their neck, trunk, shoulder, elbow, and wrist movements during the first hour of surgery. We also compared postprocedural complaints of pain, stiffness, or numbness between the two groups. Results: Compared with surgeons performing open surgery, surgeons performing laparoscopic surgery exhibited less lateral neck flexion; less trunk flexion; more internal rotation of the shoulders; more elbow flexion; more wrist supination and wrist ulnar and radial deviation. There was a trend of more shoulder stiffness after laparoscopic operations than after open operations. Conclusions: Laparoscopic surgery involves a more static posture of the neck and trunk, but more frequent awkward movements of the upper extremities than open surgery. Ergonomic changes in the operating room environment and instrument design could ease the physical stress imposed on surgeons during laparoscopic operations.

Original languageEnglish (US)
Pages (from-to)720-724
Number of pages5
JournalAmerican Journal of Surgery
Issue number6
StatePublished - 2001



  • Ergonomics
  • Laparoscopy
  • Posture

ASJC Scopus subject areas

  • Surgery

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