Work-related upper limb musculoskeletal disorders in paediatric laparoscopic surgery. A multicenter survey

Ciro Esposito, Alaa El Ghoneimi, Atsuyuki Yamataka, Steve Rothenberg, Marcela Bailez, Marcelo Ferro, Piergiorgio Gamba, Marco Castagnetti, Girolamo Mattioli, Pascale Delagausie, Dimitris Antoniou, Philippe Montupet, Antonio Marte, Amulya Saxena, Mirko Bertozzi, Paul Philippe, François Varlet, Hubert Lardy, Antony Caldamone, Alessandro SettimiGloria Pelizzo, Francois Becmeur, Maria Escolino, Teresa De Pascale, Azad Najmaldin, Felix Schier

Research output: Contribution to journalArticlepeer-review


Background Surgeons are at risk for developing work-related musculoskeletal symptoms (WMS). The present study aims to examine the physical factors and their association with WMS among pediatric laparoscopic surgeons. Methods A questionnaire consisting of 21 questions was created and mailed to 25 pediatric laparoscopic surgeons (LG). 23/25 surgeons (92%) completed the survey. The questionnaire was analyzed and then split into 2 groups. Group 1 (LG1) included surgeons with greater laparoscopic experience, and group 2 (LG2) included surgeons with less important laparoscopic experience. In addition, we constructed and sent to the same surgeons a similar questionnaire focused on WMS after an open procedure (OG) with the aim to compare results of LG with OG. Results The prevalence rate of WMS with shoulder symptoms was 78.2% in surgeons that performed laparoscopy for more than 10 years, with 60.8% also reporting other pain. In 66.6% this pain is evident only after a long-lasting procedure. Forty-four percent of these surgeons require painkillers at least twice a week. Fifty percent of these surgeons also suffer at home. Fifty-five and one half percent of surgeons indicate that this pain is related to their laparoscopic activity. Forty-three and a half percent think that laparoscopy is beneficial only for the patient but has a bad ergonomic effect for surgeons. Sixty-five and two-tenths percent think that robotic surgery can be helpful to improve ergonomics. Comparing the groups, WMS occur more frequently in LG (78.2%) than in OG (56.5%), but this difference was not statistically significant (χ2 = 0.05). In addition, WMS occur more frequently in LG1 (84.6%) than in LG2 (70%), but this difference was not statistically significant (χ2 = 0.05). Conclusions These results confirmed a strong association between WMS and the number of laparoscopic procedures performed. Skilled laparoscopic surgeons have more pain than less skilled laparoscopic surgeons. WMS in the same group of surgeons are more frequent after laparoscopy than after open procedures. The majority of surgeons refer to shoulder symptoms.

Original languageEnglish
Pages (from-to)1750-1756
Number of pages7
JournalJournal of Pediatric Surgery
Issue number8
Publication statusPublished - Aug 2013


  • Ergonomics
  • Laparoscopy
  • Shoulder pain
  • Work-related musculoskeletal symptoms

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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