ERGONOMICS Laparoscopy takes a real toll on surgeons' bodies.

Do you think much about the physical toll surgeons experience as a result of their jobs, about the wear and tear on their bodies from laparoscopy?

We didn't either until we talked to several surgeons about repetitive stress injuries and OR ergonomics for "The Aches and Pains of Laparoscopy" on page 62 of this issue.

We had no idea laparoscopy was such a grueling and physically demanding activity that took such a toll on surgeons' bodies. But operating chopstick-style with your neck, shoulders, arms, wrists and hands at odd angles and stuck in one position for hours put enormous stress and strain on the body.

"Ergonomics may be the most important issue facing surgeons today," says Howard Ross, MD, chief of colon and rectal surgery at Temple University Hospital in Philadelphia, Pa. "This is an underappreciated and an incredibly important topic."

Even though your surgeons might limp out of the OR after a day of laparoscopy feeling like a giant bruise, you might not hear them complain. Their machismo and their training won't let them.

"We're used to suffering," they say to themselves. "Medical school conditioned us to work hard."

They're also used to abusing and neglecting their bodies. If they can be on their feet for 12 hours straight on 3 hours of sleep and not eat lunch, what's a little wrist pain? So what if it hurts when they try to turn my neck to the left.

They grin and bear it rather than complain about aches and fatigue. They're taught to suck it up and tough it out, even though they risk an injury that could cut short a 30-year career.

That's where you come in. Encourage your docs to take a 90-second break during surgery to stretch. Make sure your ORs are ergonomically friendly — the HD monitors are positioned at eye level, the room is set up for the surgeon, not the assistant or the residents — and stock the latest laparoscopes, the ones with the comfortable handles. Encourage surgeons to think of their comfort so they preserve their careers.

"The key to preventing ergonomic injuries in surgeons is to make them aware, as early as possible in their careers, that they exist. They need to be aware that if they don't set the room up for their comfort, over time they will have an injury," says Dr. Ross. "They must pay attention to their own wellness. Are their shoulders relaxed? Is their hand in the correct position? Are their eyes maintained on the screen so that their neck remains neutral?"

How can surgeons advance their careers? "By taking care of our bodies," says Sharona B. Ross, MD, FACS, the director of minimally invasive surgery and surgical endoscopy at Florida Hospital Tampa. OSM