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MP76-11: Is your Career Hurting You? The Ergonomic Consequences of Surgery Over Time in 701 Global Urologists

Monday, May 15
9:30 AM - 11:30 AM
Location: BCEC: Room 156

Presentation Authors: Granville Lloyd*, Denver, CO, Amanda Chung, Concord, NSW, Australia, Mark Sawyer, Steve Steinberg, Denver, CO, Daniel Williams, Madison, WI, Douglas Overbey, Denver, CO

Introduction: Workplace injury has been long recognized; recent attention has turned to the concern that modern surgical volumes and especially laparoscopic techniques put practitioners at risk of these injuries. We surveyed urologists to seek correlations between the type, volume and duration of surgical work performed, surgeon characteristics, and the prevalence of musculoskeletal complaint and injury across career.


Methods: An anonymous web-based multi-national survey of urologists was conducted, with pain as the primary outcome. Student t-test, Fisher exact and Chi-Square tests were used for analysis.


Results: 701 complete responses were received from this multi-national survey (Figure 1). Gender, pain distribution, and private or academic practice did not correlate with pain, while exercise and lower weight and BMI were protective (Table 1). Dose-response of surgical type was assessed with high and low volume density quartiles and frequency of each pain severity (Figure 2).


Conclusions: To our knowledge, no study has assessed hard endpoints of occupational spinal injury, nor sought surgeon-protective factors. In this, the largest surgical ergonomic study to date: surgical type, duration, volume, setting, and physician gender were unrelated to surgeon pain throughout career. Female practitioners seek invasive therapy less than male counterparts. Exercise appears protective against these complaints in a dose-related fashion; increasing weight and BMI are associated with pain. North Americans report less pain than global counterparts. Practitioners of direct optical cystoscopy report no more neck trouble than others. Although 47% of urologists with spinal pain blame their career, we are unable to identify any dose-response relationship that supports that assumption.


Source Of Funding: None

Granville L. Lloyd, MD

University of Colorado

Dr. Granville Lloyd is the Director of Robotic Surgery at the Denver VA Hospital and an Assistant Professor of Surgery/Urology at the University of Colorado. He grew up in Longmont, Colorado and graduated from the University of Colorado at Boulder with degrees in Molecular Biology and Psychology.  He attended medical school at the Dartmouth-Brown program, trained in Urology at Northwestern University in Chicago and ultimately completed a fellowship in Robotic Surgery at the University of Rochester.  

Dr. Lloyd's primary research interests include both patient and surgeon factors as they apply to robotic and laparoscopic surgery.  He's a devoted skier, mountain biker and widely feared bar-league hockey player. 

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