Insights from Dr. Sadashiv Bhole at Robo-Lap 2025; Asian Institute of Nephrology & Urology Hyderabad India
The Asian Institute of Nephrology & Urology (AINU), a premier institution known for fostering cutting-edge urological and nephrological care, proudly hosted Robo-Lap 2025 at HITEX, Hyderabad — one of India’s largest and most prestigious urology conferences. This landmark event brought together leading urologists, surgeons, and global thought leaders to engage in complex case discussions, share pioneering innovations, and collaboratively shape the future of precision-driven, patient-centric care in the fields of urology and nephrology. Among the distinguished presenters, Dr. Sadashiv Bhole, a renowned robotic urology expert and surgeon wellness advocate from Nagpur, Maharashtra, delivered a compelling session that further solidified his stature as a leading authority in minimally invasive and robotic surgical techniques within Maharashtra and Central India. Dr. Bhole’s expertise and evidence-based ergonomic strategies are increasingly recognized as integral to sustaining surgeon health and optimizing operative outcomes in India’s evolving surgical landscape.
The Hidden Cost of Minimally Invasive Surgery
While laparoscopic surgery offers undeniable patient benefits—including reduced postoperative pain and accelerated recovery—the physical toll on surgeons is substantial and often overlooked. Current epidemiological data indicate that nearly 90 percent of laparoscopic surgeons endure work-related musculoskeletal pain (PMC, 2023). Bariatric surgeons report similarly high rates, from 73 to 88 percent (Bariatric Times, 2018). A global meta-analysis reveals that up to 74 percent of laparoscopic surgeons experience symptoms of MSDs, highlighting this as a pervasive occupational hazard. Dr. Bhole emphasized the urgent need for proactive educational initiatives and ergonomic interventions tailored to the Indian surgical community to mitigate this burgeoning concern.
Understanding the Burden: Most Affected Body Regions
The posterior chain muscles, encompassing regions of the neck, back, and shoulders, sustain the most strain from extended operative postures. Instrument use repetitiveness elevates risks of elbow and wrist injuries. Chronic cervical pain and lumbar discomfort can progress to disabling conditions without timely intervention. Moreover, prolonged surgeries induce unnatural stresses on the knees and ankles. Female surgeons and those with smaller glove sizes face disproportionately higher susceptibility, underscoring the need for region-specific ergonomic adaptations and customized surgical instruments.
Ergonomic Risk Factors and Practical Solutions
- Key contributors to musculoskeletal strain include prolonged awkward postures, excessive standing durations, and non-neutral grips.
- Compared to traditional laparoscopic surgery, robotic-assisted techniques facilitated by platforms such as Da Vinci offer substantial reduction in surgeon fatigue and biomechanical stress.
- Maintain a neutral posture with elbows flexed between 90 and 120 degrees.
- Position monitors slightly below eye level to reduce neck strain.
- Keep instrument handles below elbow height to minimize wrist and shoulder stress.
- Schedule ergonomic microbreaks featuring gentle stretches and relaxation.
- Incorporate anti-fatigue flooring to enhance comfort during prolonged standing.
Training for a Long and Healthy Surgical Career
Physical conditioning remains foundational for surgeon resilience. Targeted resistance training designed by Dr. Bhole zeroes in on the posterior chain muscles—neck extensors, posterior deltoids, spinal erectors, gluteals, hamstrings, and calves—to sustain posture and enhance endurance. He recommends exercises using free weights, resistance bands, calisthenics, and adaptable home workout routines, emphasizing progressive overload to build strength sustainably.
Complementary Flexibility and Mobility Exercises
Complementary flexibility and mobility exercises—including neck side bends, shoulder rolls, thoracic spine extensions, and hip flexor stretches—maintain joint health and reduce injury risks when incorporated before, after, or between surgical cases.
Cardiovascular Fitness and Ergonomic Microbreaks
To maintain stamina for demanding surgeries, surgeons should integrate brisk walking, jogging, cycling, swimming, and high-intensity interval training (HIIT) into their fitness regimen. Regularly scheduled ergonomic microbreaks reduce muscular fatigue by encouraging postural shifts, shoulder relaxation, neck stretching, and finger and wrist mobility exercises.
Innovative Technology and Future Directions
Emerging surgical technology significantly enhances surgeon ergonomics. Dr. Bhole actively supports collaborative research initiatives at premier Indian institutions such as IIT Delhi and AIIMS, focusing on the development of ergonomic surgical tools and adaptable operating room configurations. The expansion of robotic surgical systems increasingly reduces biomechanical stress on surgeon shoulders and wrists, advancing comfort, precision, and procedural success.
Conclusion: Sustaining Surgeons for the Future
Musculoskeletal disorders represent a profound occupational risk for laparoscopic and robotic surgeons. Through integrated ergonomic best practices, adoption of innovative robotic technology, and commitment to targeted physical conditioning, surgeons can maintain health, optimize performance, and extend their professional longevity. Dr. Sadashiv Bhole’s leadership at the Asian Institute of Nephrology & Urology’s Robo-Lap 2025 conference enhances the dialogue on surgeon wellness as a cornerstone of clinical excellence and innovation in India. His pioneering efforts in robotic urology and ergonomics position Maharashtra and Central India at the forefront of global surgical advancements.
Connect with Dr. Sadashiv Bhole
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