J reconstr Microsurg 2019; 35(05): 322-328
DOI: 10.1055/s-0038-1675177
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Work-Related Musculoskeletal Discomfort and Injury in Microsurgeons

Ashley L. Howarth
1  Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, Arizona
Susan Hallbeck
2  Division of Health Care Policy and Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
Raman C. Mahabir
1  Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, Arizona
Valerie Lemaine
3  Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota
Gregory R. D. Evans
4  Department of Plastic and Reconstructive Surgery, University of California, Irvine, Orange, Irvine, California
Shelley S. Noland
1  Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, Arizona
› Author Affiliations
Further Information

Publication History

21 June 2018

04 September 2018

Publication Date:
16 October 2018 (eFirst)


Background Long surgical procedures with loupe magnification and microscopes may put microsurgeons at an increased risk of musculoskeletal discomfort. Identifying the prevalence and impact of work-related musculoskeletal discomfort may guide preventive strategies to prolong well-being, job satisfaction, and career duration.

Methods An online 29-question survey was designed to evaluate work-related musculoskeletal discomfort. The survey was created and distributed electronically through a private survey research center and was sent to the members of the American Society for Reconstructive Microsurgery.

Results There were 117 respondents (16.7% response rate): 80% were men; 69% were aged 31 to 50 years; and 68% were in academic practice. On a scale of 0 to 10 (0, no pain and 10, worst pain), the median for work-related musculoskeletal discomfort for surgery without loupes or microscope was 2; with loupes, 4; and with a microscope, 5. Pain was most common in the neck. Half of the surgeons reported pain within 4 hours of surgery, and 57% feared that pain would influence future surgical performance. Surgeon discomfort affected posture (72%), stamina (36%), sleep (29%), relationships (25%), concentration (22%), and surgical speed (19%). Tremor caused by the discomfort occurred in 8%. Medical treatment for discomfort was sought by 29%. Time off work for treatment occurred for 8%.

Conclusion Work-related musculoskeletal discomfort can affect many aspects of a microsurgeon's life and has the potential to limit a surgeon's ability to operate. Therefore, more emphasis is needed in the surgical community on the important issues of occupational health and surgical ergonomics for microsurgeons.