Ten Practical Ways to Improve Your Ergonomics in the OR and Why Your Future Self Will Thank You 

Shaina Bruce, MD

Ten Practical Ways to Improve Your Ergonomics in the OR and Why Your Future Self Will Thank You

Ergonomics was not something I thought much about in training. I was more focused on learning to become a great surgeon. I’m only a few years out, but I started noticing something I didn’t expect this early in my career – near daily neck and shoulder discomfort. And it turns out, this isn’t unusual. 

Data published by Dr. Geeta Lal, a nationally recognized leader in surgical ergonomics, shows that the majority of surgeons experience work-related musculoskeletal pain, often involving the neck, shoulders, and back. Even more concerning, these issues can lead to burnout, practice modification, and even early retirement. 

After hearing Dr. Lal speak at the Wellness Committee ergonomics masterclass during the SGO 2025 Annual Meeting, I started paying more attention to my OR setup and what I was (or wasn’t) doing outside of it. 

The good news? Small changes actually make a big difference. 

1. Take microbreaks:  Short, 1–2-minute stretch breaks every 1-2 hours can significantly reduce muscle fatigue without compromising your flow or operative time. 
2. Optimize table height and patient positioning (for you):  Your elbows should rest at approximately 90 degrees with shoulders relaxed. If you’re shrugging or hunching, make adjustments. 
3. Keep monitors at eye level: Looking up or down for hours strains your neck. Align monitors directly in your line of sight to maintain a neutral cervical spine. Don’t accept poor monitor positioning.  
4. Invest in anti-fatigue mats for open or laparoscopic cases:  These reduce strain on your lower back and legs during long cases. It’s a simple intervention but may have a large impact. 
5. Master your robotic console setup: Adjust chair height (feet flat, hips neutral), armrests (support forearms, not elbows dangling), viewer position (avoid neck flexion). Poor console setup can quietly lead to chronic neck, shoulder, and wrist issues. 
6. Find a chair that actually supports you: If you are doing robotic surgery regularly, a supportive chair is essential. Lumbar support and proper height (along with a chair that actually locks in place) will make a noticeable difference by the end of the day.  
7. Account for height differences: Not everyone at the table is the same height and operating table height is often optimized for one person, not the entire team. That can leave assistants or co-surgeons working in uncomfortable positions for prolonged periods. The table height should be adjusted for the tallest team member while others use 1 or 2 step stools (with anti-fatigue mats!) 
8. Be thoughtful about headlamps: In Gynecologic Oncology, we often rely on headlamps during open cases. Over time, frequent use can contribute to chronic neck strain. Lighter weight models are available, including some that clip directly onto surgical glasses rather than using a full headband. Another key factor is how your light aligns with your natural line of sight. If you’re constantly flexing your neck to optimize visualization, that strain adds up over time. 
9. Build strength and flexibility outside of the OR: One of Dr. Lal’s recurring themes is thinking of surgeons as “occupational athletes.” Athletes don’t just show up and perform, they train. For me, that’s meant incorporating power yoga into my weekly routine, along with being more intentional about stretching. The neck and shoulder discomfort that used to feel like a daily occurrence has all but gone away. 
10. Create a culture of ergonomic awareness: Normalize speaking up about setup, taking breaks, and optimizing your OR environment for yourself and for your team. 

I didn’t expect to be dealing with near daily neck and shoulder discomfort this early in my career. But I also didn’t expect how much better I would feel after making a few key changes. Being more deliberate about setup, taking time to stretch during long cases, and prioritizing movement outside of the OR has made a noticeable difference. The discomfort that used to feel like part of the job has mostly gone away. 

None of this is complicated, but it does take intention. It’s easy to move quickly through setup or push through a long case without stopping.  I still do that sometimes, but I’m trying to be more aware of it now. 

We spend years learning how to operate. Paying attention to how we take care of our bodies is what allows us to keep doing it. 

Dr. Shaina Bruce is a gynecologic oncologist at Penn State Health and a member of the SGO Wellness Committee.

References  

1. Jensen MJ, Pagedar NA, Sugg SL, Lal G. Endocrine surgeons have high rates of work-related musculoskeletal (MSK) injury and symptoms. Am J Surg. 2022;224(1):315-318. doi:10.1016/j.amjsurg.2021.11.026