To identify shoulder and neck motion and muscle activity during simulated ureteroscopy (URS) using a non-optimized and ergonomically optimized operating room setup.

Eight surgeons performed simulated URS in a biomechanics motion analysis lab, replicating the least ergonomically designed local operating room (non-optimized setup). Licensed physical therapists made individualized adjustments to the monitor and table, and simulated URS was repeated (optimized setup). During simulations, neck and shoulder motion was assessed using optical motion capture cameras and muscle activity was measured using surface electromyography. Surgeons rated their pain and perceived exertion after each trial.

Participants used more cervical extension (14.3° vs 13.0°, P < .01), left lateral bending (11.7° left vs 4.9° right, P < .01), and right rotation (26.5° right vs 3.1° left, P < .01) in the non-optimized setup compared to optimized. Cervical extensor activity was higher in the non-optimized setup compared to optimized on the right (159% resting activity vs 118%, P = .03) and left (130% vs 111%, P = .01). Perceived exertion was lower in the optimized setup ( P = .02).

Simple changes to operating table and monitor positioning resulted in significant improvement in neck motion and muscle activity. These findings support ergonomics training for urologists which may reduce the incidence of musculoskeletal pain in these clinicians.