Editorial Comment for Gözen et al.

I congratulate the authors for addressing the importance of ergonomics affecting the well-being of surgeons during laparoscopic surgery.

Few studies addressed the consequences of a laparoscopic surgeon's ergonomics during surgery. Uhrich and associates ¹ reported the fatigue of laparoscopic surgeons from the static contraction of muscle groups from the neck down to the lower extremities. Moreover, Park and colleagues ² reported that 87% of surgeons performing minimally invasive procedures suffer from physical pain or discomfort. Therefore, the concept of an ergonomic chair for laparoscopic surgeons is sought after but not widely investigated by the medical device industry.

The ETHOS™ chair with adjustable resting arms for the elbow facilitates a resting position of the shoulders and arms, facilitating the surgeon's position during laparoscopic surgery. ³ This article compare three types of positions during a pelvic suturing exercise mimicking the clinical scenario of laparoscopic urethrovesical anastomosis (UVA). The “bad” effects of uncomfortable posturing during the laparoscopic exercises were evaluated and illustrated. Although it seems intuitive that good posture and relaxed muscles are pivotal during a surgical procedure, these data demonstrate the superiority of the ETHOS ergonomic device when compared with other positions during the laparoscopic UVA regarding surgeon's pain level and discomfort. Ultimately, the effectiveness in the operating room depends on surgeon and patient safety including long-term well-being of the work force.