The trainees' pain with laparoscopic surgery: what do trainees really know about theatre set-up and how this impacts their health

Although it is clear that laparoscopic surgery is beneficial to the patient, such surgery brings with it unique challenges and possible injury to the surgeon. Firstly, we sought to investigate the prevalence of musculoskeletal distress experienced by trainees. Secondly, we sought to ascertain if the trainees had received appropriate instruction to optimise their operative environment during laparoscopic surgery. An anonymised questionnaire survey was distributed to all 89 trainees in obstetrics and gynaecology within Northern Ireland. Forty-four (83%) trainees reported to having received formal instruction in theatre layout and operating body position. However, only 8(15%) were aware of the ideal operating surface height, and 6(11%) knew the ideal monitor position, while 11(20%) and 7(13%) knew the correct angles for grasping and suturing tissue, respectively. Eightyfive percent of trainees suffered some formofmusculoskeletal distress with back, shoulder and neck pain the most common areas affected. Eyestrain was reported by 1/3 of trainees. Although no trainees required sick leave, one in three required regular analgesia, physiotherapy or alternative therapies. It is clear that current training has not addressed operating ergonomics sufficiently, and this is having a significant impact on trainees' health.