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standing? If so, they should toggle between the two whenever
possible during lengthier surgeries.
• Platforms with rails. Risers are often used by shorter sur-
geons in ORs, but surgeons have been injured falling from them.
Ms. Pentico recommends using wide platforms with rails. You'll
want to consult infection control, however, because the rails
could be in the sterile field.
• Better-fitting instruments. When an instrument doesn't fit
right, surgeons often contort themselves to correct for the
ergonomic deficiency, which can lead to injury. Look not only for
better fit, but other ergonomic features, too. "Some laparoscopic
tools now articulate, so the surgeon doesn't need to bend into
awkward positions," says Ms. Pentico. "The scope does most of
the bending for them."
• Improved positioning. The patient should be as close to the
surgeon as possible, with the table height adjusted and tilted as
needed. Balance access and comfort as well as you can.
• Two surgeons, one case. Alternating with the resident allows
the attending and resident to separately take breaks or mini-
pauses.
• Equipment holders. Surgeons often hold equipment for long
periods. Can you provide holders for equipment so they can
release their grasp without putting the equipment down?
• Modified culture. Microbreaks as short as 30 seconds and
stretch breaks can improve surgeon focus and comfort, but may
not normally be practiced. This would require the support of the
attending and administrators. The first step toward establishing
an ergonomic program for surgeons is education on risk factors
they face and initiating basic modifications that can be immedi-
