Obstetrics and Gynaecology trainees face higher musculoskeletal demands than General Surgery trainees in simulated laparoscopic tasks - an observational study

Khan, Zaibun and Shugaba, Abdulwarith and Davitt, Matt and Shrestha, Donna and Lambert, Joel and Clark, Justin and Bampouras, T.M. and Hayes, Lawrence and Nuttall, Helen E and Subar, Daren and Sanal-Hayes, Nilihan and Gaffney, Christopher (2025) Obstetrics and Gynaecology trainees face higher musculoskeletal demands than General Surgery trainees in simulated laparoscopic tasks - an observational study. Healthcare, 13 (24): 3223. ISSN 2227-9032

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Abstract

Background/Objectives: Laparoscopic surgery has become the pre-eminent surgical approach for performing general surgical and gynecological operations, but it can lead to musculoskeletal disorder in surgeons. This study aimed to investigate the musculoskeletal demands of completing four core laparoscopic skills tasks amongst Obstetrics and Gynecology (O&G) and General Surgery (GS) trainees, recognizing that differences between specialties may create different ergonomic and muscular demands. Methods: Ten O&G and ten GS trainees both performed the same four tasks to evaluate their core laparoscopic skills whilst using electromyography (EMG) to assess the physical demand of each task in the trainee groups as a percent of maximum voluntary contraction. Results: O&G trainees had significantly higher muscle activity when completing a hand–eye coordination (HEC) task (167.9 ± 63.8 vs. 92.5 ± 31.3%, p = 0.019), bimanual coordination (BMC) task (205.6 ± 80.7 vs. 106.9 ± 47.0%, p = 0.017), and suturing (267.7 ± 121.6 vs. 122.2 ± 33.0%, p = 0.016) task in the right trapezius and deltoid muscle groups compared to GS trainees. No difference was observed between trainee groups in the laparoscopic camera navigation (LCN) task (p = 0.438). Conclusions: There appears to be increased muscular activity in O&G compared to GS trainees during the same simulated laparoscopic tasks. The findings should inform training policy around the optimization of ergonomics to minimize the risk of musculoskeletal disorder.