Ergonomics in the O.R.Ergonomics in the O.R.

1 • Ergonomics in the Operating Room

Ergonomics in the Operating Room • 2

Ergonomics in the Operating Room

Operating room staff are known to have several risk factors for musculoskeletal disorders including the following:¹

These risk factors have led to a high rate of musculoskeletal disorders amongst surgeons and operating room staff, with reported discomfort due to operating room tasks ranging from 66 - 94% with pain typically occurring in the hands, arm, neck, low back and shoulders(Fig. 1).2

Uncomfortable postures Prolonged standing Holding retraction forextended time

Prolonged fixed posturesPulling/pushing equipment and/or patients during surgery.

Figure 1. Possible areas of discomfort or injuries to O.R staff and surgeons - hands, arm, neck, low back and shoulders.

3 • Ergonomics in the Operating Room

Ergonomics in the Operating Room • 4

Ergonomics Needed in the Operating Room

Broadly defined, the goal of ergonomics is to prevent soft tissue injury and musculoskeletal disorders caused by exposure to force, repetitivemotion, vibration and awkward posture.3 Practically, ergonomics is the concept of designing a working environment to fit the worker, rather than forcing the worker to fit the environment.2 While principles of ergonomics have been applied in various industries since the early 1900s4, in the medical field, ergonomics applications didn’t gain interest until the early 1980s, with adoption of ergonomic principles continuing to be slow, even today. In the operating theatre in particular, one of the main ergonomic considerations is visual exposure of the surgical field. Exposure can be aided by proper positioning of the patient and the application of retractors to the wound and internal tissues.5

The shoulder/upper arm should remainperpendicular to the floor

The angle between the forearm and upperarm should be 90º

Neck flexion should be about 20º and excessivehead forward posture should be avoided as thiscan increase damage to the cervical spine

Short breaks should be undertakenapproximately every 20 minutes during asurgical procedure

The forearm should be held in a horizontalposition, parallel to the floor and in a neutralposition between supination and pronation

Extreme wrist excursions should notoccupy >30% of operating time

Ergonomics Guidelines

In order to help with surgical ergonomics, the AORN in 2011 recommended the use of self-retaining retractors whenever possible.6

Further, several recommendations have been put forth in ergonomic guidelines for surgeons and OR staff including:²

5 • Ergonomics in the Operating Room

Lack of Ergonomics Implementation

Despite surgeon and OR staff understanding of the importance of ergonomics within the operating room, there are several reasons for alack of implementation of such solutions. Unlike other industries, standardization is difficult due to human anatomy, each patient’s surgeryis unique, and different surgeons often use different surgical approaches and set-up for similar procedures.7

Ergonomics in the Operating Room • 6

The Walter Difference

The WalterLorenzTM Surgical Assist Arm is a bionic, electromechanical arm that enables surgical site optimization. The Walter Arm wascreated in collaboration with surgeons across multiple disciplines to assist with visual access, flexibility, and efficiency during surgicalprocedures. The Walter Arm is designed to retract tissues with steady pressure, alleviating the retraction burden and associated ergonomic/injury risks to the surgeon and operating room staff. By providing a stable platform, the Walter Arm may help to reduce fatigue and stress in operating room personnel, thereby reducing injury to surgical staff and improving overall surgical ergonomics to enhance operative efficiency and safety.

For more information on Integrated Procedural Solutions and SAT, please contact us at:

BIOMET MICROFIXATION GLOBAL HEADQUARTERS1520 Tradeport Drive • Jacksonville, FL 32218-2480 • Tel 904.741.4400 • Toll-Free 800.874.7711

Fax 904.741.4500 • Order Fax 904.741.3059 • www.zimmerbiomet.com

EUROPEToermalijnring 600 • 3316 LC Dordrecht • The Netherlands • Tel +31 78 629 29 10 • Fax +31 78 629 29 12

All content herein is protected by copyright, trademarks and other intellectual property rights owned by or licensed to Zimmer Biomet, Inc. or its affiliates unless otherwise indicated, and must not be redistributed, duplicated or disclosed, in whole or in part, without the express written consent of Zimmer Biomet. This material is intended for healthcare professionals and the Zimmer Biomet sales force. Distribution to any other recipient is prohibited. Zimmer Biomet does not practice medicine. Because this information does not purport to constitute any diagnostic or therapeutic statement with regard to any individual medical case, each patient must be examined and advised individually, and this information does not replace the need for such examination and/or advice in whole or in part. Each physician should exercise his or her own independent judgment in the diagnosis and treatment of an individual patient. Check for country product clearances and reference product-specific instructions for use. For complete product information, including indications, contraindications, warnings, precautions and potential adverse effects, see the package insert or www.zimmerbiomet.com.

©2019 Zimmer Biomet • www.zimmerbiomet.com • Form No. BMF00-8850 • Rev 0-3k1902-2099

References

1. Maozzami Z et al. Effect of an ergonomics-based educational intervention based on transtheoretical model in adopting correct body posture among operating room nurses. Global J Health Sci. 2016; 8(7): 26-34.

2. Catanzarite T et al. Ergonomics in surgery: A review. Female Pelvic Med and ReconSurg. 2018; 24(1): 1-12.

3. National Institute for Occupational Safety and Health (NIOSH), Centers for DiseaseControl and Prevention (CDC). www.cdc.gov/niosh/topics/ergonomics/default.html

4. Gilbreth F. Motion study. Princeton, NJ: D Van Nostrand; 1911

5. Berguer, Ramon. Surgery and Ergonomics. Arch Surg. 1999; 134:1011-1016.

6. Spera P et al. AORN ergonomic tool 5: Tissue retraction in the perioperative setting. 2011; 94(1):54-58.

7. Stucky CCH et al. Surgeon symptoms, strain, and selections: Systematic review andmeta-analysis of surgical ergonomics. Annals Med Surg. 2018;27:1-8.

All content herein is protected by copyright, trademarks and other intellectual property rights owned by or licensed to Zimmer Biomet, Inc. or its affiliates unless otherwise indicated, and must not be redistributed, duplicated or disclosed, in whole or in part, without the express written consent of Zimmer Biomet. This material is intended for healthcare professionals and the Zimmer Biomet sales force. Distribution to any other recipient is prohibited. Zimmer Biomet does not practice medicine. Because this information does not purport to constitute any diagnostic or therapeutic statement with regard to any individual medical case, each patient must be examined and advised individually, and this information does not replace the need for such examination and/or advice in whole or in part. Each physician should exercise his or her own independent judgment in the diagnosis and treatment of an individual patient. Check for country product clearances and reference product-specific instructions for use. For complete product information, including indications, contraindications, warnings, precautions and potential adverse effects, see the package insert or www.zimmerbiomet.com.

©2019 Zimmer Biomet • www.zimmerbiomet.com • Form No. BMF00-8850 • Rev 0-3k1902-2099

References

1. Maozzami Z et al. Effect of an ergonomics-based educational intervention based on transtheoretical model in adopting correct body posture among operating room nurses. Global J Health Sci. 2016; 8(7): 26-34.

2. Catanzarite T et al. Ergonomics in surgery: A review. Female Pelvic Med and ReconSurg. 2018; 24(1): 1-12.

3. National Institute for Occupational Safety and Health (NIOSH), Centers for DiseaseControl and Prevention (CDC). www.cdc.gov/niosh/topics/ergonomics/default.html

4. Gilbreth F. Motion study. Princeton, NJ: D Van Nostrand; 1911

5. Berguer, Ramon. Surgery and Ergonomics. Arch Surg. 1999; 134:1011-1016.

6. Spera P et al. AORN ergonomic tool 5: Tissue retraction in the perioperative setting. 2011; 94(1):54-58.

7. Stucky CCH et al. Surgeon symptoms, strain, and selections: Systematic review andmeta-analysis of surgical ergonomics. Annals Med Surg. 2018;27:1-8.

For more information on the WalterLorenz™ Surgical Assist Arm and Surgery Assisting Technology,

please contact us at:

BIOMET MICROFIXATION GLOBAL HEADQUARTERS1520 Tradeport Drive • Jacksonville, FL 32218-2480 • Tel 904.741.4400 • Toll-Free 800.874.7711

Fax 904.741.4500 • Order Fax 904.741.3059 • www.zimmerbiomet.com

EUROPEToermalijnring 600 • 3316 LC Dordrecht • The Netherlands • Tel +31 78 629 29 10 • Fax +31 78 629 29 12