Ergonomic Challenges for Surgeons; The Problem and Solutions

April 14, 2025 updated by: University Hospital Plymouth NHS Trust

Characterisation of the Postures Encountered During Surgery and Development of Strategies to Reduce the Risk of Developing Work-related Musculoskeletal Disorders in Surgeons

Work-related musculoskeletal disorders (WMSDs) are highly prevalent among surgeons. Despite growing awareness, there remains a lack of detailed data on the specific postures that contribute to ergonomic risk, particularly within General Surgery. This study aims to characterise postures encountered during open, laparoscopic, and robotic gastrointestinal procedures using wearable sensor technology and video analysis, to inform future ergonomic interventions and training.

A single-centre, prospective observational study of 30 surgical cases will be conducted at University Hospitals Plymouth NHS Trust. Participating surgeons will wear inertial measurement units (IMUs) to record real-time body segment position data whilst performing live surgery. A biomechanical model will then be used to calculate joint angles and whole body posture. Video recordings will be synchronised with IMU data to map posture to surgical tasks. Static and dynamic postures will be analysed using standard ergonomic assessment tools. Alternative tools tailored to surgery will be assessed and proposed. Surgeons will complete questionnaires pre- and post-operatively to report musculoskeletal symptoms. Outcomes will compare ergonomic risk across surgical techniques, identify high-risk procedural steps, and assess the acceptability of wearable technologies in the operating theatre. The data generated will also be used to evaluate, train or refine artificially intelligent camera-based pose estimation models for the operating theatre environment in order to make future ergonomics research and assessment more accessible.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Surgeons often spend long hours in physically demanding positions, which can lead to work-related musculoskeletal disorders (WMSDs) such as neck, shoulder, and back pain. These issues can impact a surgeon's well-being, career longevity, and surgical performance. This study aims to understand the ergonomic challenges surgeons face during major gastrointestinal (GI) surgeries, including open, laparoscopic (keyhole), and robotic procedures. By analysing their posture during operations, researchers hope to develop strategies to reduce the risk of injury.

The study will recruit general surgeons from University Hospitals Plymouth NHS Trust who perform or assist in GI surgeries. Using small motion sensors (Inertial Measurement Units, or IMUs) placed on the surgeons' bodies, researchers will track joint movements, body positions, and posture throughout different surgical techniques. This will help identify which postures and surgical steps are associated with the highest ergonomic risk. Video recordings of surgeries will also be collected to analyse movements and develop future training tools.

Surgeons will complete questionnaires before and after surgery to report any discomfort or pain. The study will compare different surgical techniques to determine which carries the highest risk of injury and which aspects of surgery contribute to poor ergonomics.

By identifying high-risk postures and steps within procedures, this research aims to provide recommendations for ergonomic improvements, such as better training, surgical workstation adjustments, or new tools to help surgeons maintain healthier postures. The results could lead to improved surgeon well-being, safer surgical practices, and longer career sustainability. Findings from this study will be used to develop educational materials and future research in surgical ergonomics.

This study is observational and does not require any changes to standard surgical practice. Both surgeons and patients will provide consent before participation, ensuring ethical research practices.

Study Type

Observational

Enrollment (Estimated)

30

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Probability Sample

Study Population

Surgeons Performing Major Upper GI Surgery at University Hosptials Plymouth NHS Trust

Description

Inclusion Criteria:

  • Surgeons performing gastro-intestinal (GI) surgery
  • Surgeons assisting GI surgery
  • Open, laparoscopic and robotic GI operation
  • Informed consent from surgeon
  • Informed consent from patient

Exclusion Criteria:

  • Pre-existing severe practice-limiting musculoskeletal disorder
  • Surgeon not consenting to participation
  • Patient not consenting to participation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Joint angle.
Time Frame: During the operative period, from initial incision to final closure.
Joint angles (in degrees)
During the operative period, from initial incision to final closure.
Posture duration.
Time Frame: During the operative period, from incision to closure
The duration of characterised postures (in minutes)
During the operative period, from incision to closure
Posture Variability
Time Frame: During the operative period, from incision to closure
Angles (in degrees/minute)
During the operative period, from incision to closure
Ergonomic Risk
Time Frame: During the operative period, from incision to closure
RULA Score will be calculated
During the operative period, from incision to closure

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Compare open, laparoscopic and robotic techniques
Time Frame: During the operative period, from incision to closure
Joint angles (in degrees)
During the operative period, from incision to closure
Compare open, laparoscopic and robotic techniques
Time Frame: During the operative period, from incision to closure
Postural variability (in degrees/minute)
During the operative period, from incision to closure
Identify specific surgical procedures which carry high ergonomic risk
Time Frame: Pre-procedure, immediately post procedure and 24 hours after end of procedure.

Musculoskeletal symptoms will be assessed pre, intra and post operatively using a self-reported modified Borg CR10 scale symptom questionnaire.

Sensor and symptom data will be correlated with procedure and technique type.
Pre-procedure, immediately post procedure and 24 hours after end of procedure.
Create a video library for use in development of educational/training/monitoring tools
Time Frame: During the operative period, from incision to closure
Video footage of the surgeon will be recorded during the procedure and stored, both for postural assessment during this study and for the creation of a data set that can be used to create a camera vision-based system for further data collection, development of further research and training tools.
During the operative period, from incision to closure
Determine the acceptability of sensor-based methods for recording posture data during GI surgery
Time Frame: During the operative period, from incision to closure
Surgeons will be surveyed regarding their experience of using IMUs for collecting posture data during surgery and this will be used to assess the acceptability of this technology for recording posture data for GI surgery.
During the operative period, from incision to closure

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Hospital Plymouth NHS Trust

Collaborators

University of Plymouth

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 1, 2025

Primary Completion (Estimated)

December 1, 2025

Study Completion (Estimated)

August 1, 2026

Study Registration Dates

First Submitted

April 7, 2025

First Submitted That Met QC Criteria

April 14, 2025

First Posted (Actual)

April 22, 2025

Study Record Updates

Last Update Posted (Actual)

April 22, 2025

Last Update Submitted That Met QC Criteria

April 14, 2025

Last Verified

April 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 24WBG122
  • 350363 (Other Identifier: IRAS)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

An anonymised video and motion data library will be shared.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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