Posture when operating

[310prolene]

Anyone have any good tips / tricks for maintaining good posture when operating?

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[HighPriest]

keep the table as low as possible. lean over the patient. Don't let your junk touch the table, that's for sure. bend your neck as much as possible. If possible, wear a headlight at all times. If you don't feel stress in your lower back or shoulders after the case is over, you're not working them out like you're supposed to. if you do a lot of endoscopic work, make sure that the screen you're watching is really high. You should be looing up at it. If possible, place it either well above the head or below the patient's feet, not directly across from you. Make sure the bovie petal is just out of reach the entire time. Let the scrub dictate where they want to be, and don't have them move even if they're kind of in your way.

the key is that if there's going to be a problem, you'll notice it right away, not 20 years from now.

 

[armybound]

Hopefully it's something you just come to notice. I know that, at first, you're concerned about sterility, then steps, then technique. But all of this should be done while you're comfortable. You shouldn't feel awkward or in any pain. Pay attention to how you feel while you're operating, and adjust as needed.

Now, I set things to where I'm comfortable, and then I start operating. I don't want to have to adjust in the middle of everything.

 

[dpmd]

Once you have control over table placement and everything it gets to be easier but you have to choose to make it a priority (so many of us will just make do with where stuff is and end up with bad ergonomics that would be simple to fix). Put the table at the right height for you, don't be scared to use steps if you can't make the bed go low enough. Keep your hands below your shoulders and your elbows as close as possible to the body during laparoscopic cases. Make a conscious effort to keep your shoulders down instead of up by your neck, same with keeping chest up and shoulders back. Move your laparoscopic screen to wherever you can keep a neutral head position. Basically if you do all you can to set things up as ergonomically as possible your posture will be good more frequently.

 

[OrthoTraumaMD]

If you’re tall, don’t hunch over the table—raise it until you feel like you’re upright.

 

[TypeADissection]

You just have to be cognizant of it because all of the little things you do now will affect your ability to practice 10-20 years down the road, if not sooner. I'm doing a much better job of posture now in fellowship than at any point in my residency exactly because of this reason and my attendings are actually much more attuned to making sure my posture is optimized.

 

[HighPriest]

Being more serious, just the reverse of everything I said above (I'm sure that was obvious).

And as stated here: you have to pay attention to it. When you're training, you're so focused on just doing the surgery right that the last thing that crosses your mind is your posture, and even less commonly what effects it will have in 20 years. As you get more comfortable with the surgery part, you can start to be more cognizant of you posture. But the best thing you can do now is to make sure that you're comfortable before you even start. Unless the patient is crashing, you have a couple of minutes to adjust the table, the mayo, the video screen, your headlight, your scrub, your bovie pedal - all of those little things add up. Get comfortable. Set things up so that your natural inclination before you start operating is to be in a position with good posture.

 

[MediCane2006]

I had a couple attendings in residency who were draconian about posture...like they would rap your knuckles with an instrument if you were hunching or slumping. At the time I rolled my eyes, but I am so grateful now because it’s instinctive to stand up straight and adjust the table if I find myself hunching. I try to remind my residents too....I recently found out from the residents that I have the reputation as the “Posture Princess” so I guess it’s working....

 

[dpmd]

I had a couple attendings in residency who were draconian about posture...like they would rap your knuckles with an instrument if you were hunching or slumping. At the time I rolled my eyes, but I am so grateful now because it’s instinctive to stand up straight and adjust the table if I find myself hunching. I try to remind my residents too....I recently found out from the residents that I have the reputation as the “Posture Princess” so I guess it’s working....

I do this with students (don't have residents now). I also work with one of my prior attendings and I am always getting on his case to use steps if the patient is too big for the table's lowest position to be low enough.