By Dr. Sadashiv Bhole, Leading Robotic Surgery Expert in Central India.
Laparoscopic and robotic surgery have revolutionized patient care by enabling minimally invasive procedures, reducing pain, accelerating recovery, and lowering complication rates. However, these advances come with significant physical demands on surgeons, often overlooked. High prevalence of musculoskeletal disorders (MSDs) among laparoscopic surgeons poses serious occupational risks affecting quality of life, career longevity, and operative performance.
Prevalence and Scope of Musculoskeletal Disorders Among Surgeons
Musculoskeletal disorders are a pervasive problem in the surgical community, particularly among minimally invasive practitioners. Studies reveal that up to 90% of laparoscopic surgeons experience work-related musculoskeletal pain (PMC, 2023). Bariatric surgeons report similar prevalence between 73% and 88% (Bariatric Times, 2018). Laparoscopic surgeons show 86% MSD prevalence compared to 76% among general surgeons (BMC, 2025). Meta-analyses (MDPI, 2024) highlight the global scale and occupational severity of this issue. Common symptoms include chronic neck, upper and lower back pain, shoulder strain, and upper limb tendinopathies, which can silently compromise surgical dexterity and endurance.
Biomechanical Insights: Regions at Greatest Risk
Research and clinical experience indicate that posterior chain muscles—including cervical and thoracic spine extensors, trapezius, rhomboids, gluteals, and hamstrings—are primary areas stressed by prolonged postures and repetitive instrument use. Altered biomechanics increase compressive forces on intervertebral discs and stress tendons around shoulders and wrists, accelerating degenerative and overuse injuries. Female surgeons and those with smaller body frames are particularly at risk due to non-optimized instruments and operating room setups.
Ergonomic Challenges and Risk Factors
- Sustained awkward postures, especially neck and trunk flexion, magnify spinal load and induce fatigue.
- Prolonged standing reduces venous return and muscular endurance.
- Repetitive gripping and instrument manipulation increases stress on wrist and forearm tendons.
- Non-ergonomic instrument design, with fixed shaft lengths and handle sizes, creates inefficient wrist angles.
- Suboptimal OR setup, including monitor height and port placements, forces maladaptive postures.
Physical Conditioning for Surgical Longevity
Robust conditioning tailored to laparoscopic demands is essential. Dr. Sadashiv Bhole advocates resistance training targeting neck extensors, posterior deltoids, paraspinal muscles, gluteus maximus, hamstrings, and calves to build dynamic stability and endurance. Progressive overload ensures safe continuous muscular adaptation. Methods include free weights, resistance bands, calisthenics, and bodyweight exercises customized for surgeons.
Flexibility and Joint Mobility
Maintaining soft tissue elasticity and joint range of motion through structured stretches enhances postural control and reduces injury. Recommended exercises include neck side-bending, controlled cervical rotations, shoulder rolls, thoracic extensions, doorway chest stretches, and hip flexor stretches pre- and post-operation, as well as during breaks.
Cardiovascular Fitness Enhances Endurance
Endurance training complements strength programs by improving cardiovascular capacity. Activities like brisk walking, jogging, cycling, swimming, and HIIT increase stamina, promote oxygen delivery to fatigued tissues, and support rapid recovery from intense surgical schedules.
Microbreaks: Small Changes, Big Impact
Intraoperative microbreaks—subtle posture shifts, scapular relaxation, deep breathing, neck stretches, and hand mobility exercises—interrupt static load accumulation, supporting sustained performance and reducing MSD incidence.
Innovations in Instrumentation and OR Ergonomics
Optimized surgical tool and OR design reduce strain. Trocar triangulation (15–20 cm inter-port distance) and instrument customization tailored to surgeon anatomy minimize awkward postures. Dr. Bhole collaborates with AIIMS and IIT Delhi to advance ergonomic surgical technologies and adaptable OR setups.
Robotic Surgery: Transforming Central India’s Surgical Landscape
Dr. Bhole’s introduction of the Da Vinci robotic platform to Central India marks a regional medical milestone. His pioneering work positions him as a distinguished robotic surgeon, integrating advanced technology with ergonomic strategies for sustainable surgical careers.
Conclusion: A Holistic Paradigm for Surgeon Wellness
Addressing MSDs in laparoscopic and robotic surgery requires a holistic approach encompassing ergonomics, physical conditioning, and technological innovation. Dr. Sadashiv Bhole exemplifies this integrative ethos, combining robotic surgery advancements with tailored fitness and ergonomic strategies to ensure healthier careers and improved patient outcomes.
References
- PMC (2023) – Epidemiological data on surgeon MSDs
- Bariatric Times (2018) – MSD findings in bariatric surgery
- BMC Musculoskeletal Disorders (2025) – Comparative prevalence studies
- MDPI (2024) – Global systematic reviews of laparoscopic surgeon MSDs
- AIIMS, IIT Delhi – Innovations in surgical ergonomics research
