With recent technological advancement, new and improved endoscopic instruments and laser devices have catapulted flexible ureteroscopy (fURS) to the forefront, hence making retrograde intrarenal surgery (RIRS) a popular choice for the management of renal stones.
However, RIRS has also resulted in an increasing number of work-related musculoskeletal disorders, which can have a detrimental impact on surgeons' physical health and operative lifespan. The aim of our review is to examine the impact and feasibility of ergonomic adjustments, and outline future directions and recommendations in order to improve the awareness of and reduce the prevalence of musculoskeletal injuries among urologists.
This study was carried out according to the PRISMA guidelines. A thorough literature review was conducted of several databases using the following keywords and Medical Subject Headings (MeSH) terms to generate a search strategy: nephrolithiasis, kidney calculus, renal calculus, staghorn calculus, ergonomics, position, fatigue, comfort, tire, physical strain, visual strain, muscle, ureteroscopy (URS), retrograde intrarenal surgery (RIRS), laser, and lithotripsy. Studies were chosen for inclusion by reviewers independently, and the data was consolidated for analysis.
A total of 1446 articles were identified on initial literature search; 23 were included in the final analysis. The impact of various ergonomic modifications on operative outcomes, surgeons, surgical equipment, and patients, was analysed. In addition, we summarized all the improvements that resulted in better ergonomics in RIRS.
Ergonomics in RIRS is poorly understood and there are currently no formal guidelines for this aspect. While modern endourology armamentarium seems to help with procedural ergonomics, more needs to be done to enhance surgeon comfort, protect surgeon longevity, and prioritize the health and safety of endourologists.
Journal of endourology. 2021 Jul 01 [Epub ahead of print]
Chloe Ong, Daniele Castellani, Dmitry Gorelov, Irene Girón-Nanne, K G Jyothi Swaroop, Mariela Corrales, Meshari Alshaashaa, Vinson Ws Chan, Bm Zeeshan Hameed, Sung Y Cho, Pradeep Durai, Nariman Gadzhiev, Saeed Bin Hamri, Deepak Reddy Ragoori, Esteban Emiliani, Silvia Proietti, Guido Giusti, Bhaskar K Somani, Olivier Traxer, Jeremy Y C Teoh, Vineet Gauhar
Ng Teng Fong General Hospital, 242949, Urology, 1 Jurong East Street 21, Singapore, Singapore, 609606; ., Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, Ancona, Marche, Italy; ., Pavlov First Saint Petersburg State Medical University, 104721, Urology, Sankt Peterburg, Sankt Peterburg, Russian Federation; ., Fundació Puigvert, 16444, Barcelona, Catalunya, Spain; ., Asian Institute of Nephrology and Urology, 519389, Hyderabad, Telangana, India; ., Hospital Tenon, 55705, Urology, 4 Rue de la Chine, Paris, Île-de-France, France, 75020; ., King Saud bin Abdulaziz University for Health Sciences College of Medicine, 48150, Riyadh, Saudi Arabia; ., University of Leeds Faculty of Medicine and Health, 120727, Leeds, West Yorkshire, United Kingdom of Great Britain and Northern Ireland; ., Kasturba Medical College Manipal, Manipal Academy of Higher Education, Urology, Kasturba Medical College, Manipal, Manipal, Karnataka, India, 576104; ., Seoul National University Hospital, 58927, Urology, Jongno-gu, Seoul, Korea (the Republic of); ., Ng Teng Fong General Hospital, 242949, Urology, Singapore, Singapore; ., Pavlov First Saint Petersburg State Medical University, 104721, Urology, Lva Tolstogo 17, Saint Petesrburg, Russian Federation, 197022; ., King Saud bin Abdulaziz University for Health Sciences, 48149, Urology, Riyadh, Saudi Arabia; ., Asian Institute of Nephrology and Urology, 519389, Urology, Hyderabad, Telangana, India; ., Fundacio Puigvert, 16444, Urology , Cartagena 340-350, Barcelona, Cataluña, Spain, 08025., San Raffaele Hospital, 9372, European Training Center of Endourology, Milano, Lombardia, Italy; ., San Raffaele Hospital, 9372, European Training Center of Endourology, Milano, Lombardia, Italy; ., University Hospitals Southampton NHS Trust, Urology, Southampton, United Kingdom of Great Britain and Northern Ireland; ., Sorbonne Universite, 27063, GRC#20 Lithiase Urinaire, Hôpital Tenon, Paris, Île-de-France, France; ., The Chinese University of Hong Kong, 26451, S.H. Ho Urology Centre, Department of Surgery, Hong Kong, Hong Kong; ., Ng Teng Fong General Hospital, 242949, Urology, Singapore, Singapore; .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/34210171