Sarah Razavi, MD, outlines strategies for mitigate surgeon discomfort during URS

A recent study published in Urology evaluated the physical toll of performing flexible ureteroscopy. In this interview, study author Sarah Razavi, MD, offers immediate, practical recommendations to mitigate fatigue and discomfort experienced by urologists performing flexible ureteroscopy. A key takeaway is the need for greater awareness of ergonomic challenges.

One crucial recommendation is incorporating an ergonomic training module into the curriculum, starting early in training to make it an ingrained part of practice. Mentors in academic programs should dedicate a few minutes before surgery to ensure proper monitor height and foot pedal placement, emphasizing the importance of ergonomics to trainees.

Razavi also suggests integrating strengthening exercises into surgical training, as simple core exercises can significantly reduce discomfort after long procedures. Micro-breaks, even as short as 40 seconds, are highlighted as an underestimated yet effective way to alleviate fatigue by allowing surgeons to reset from awkward positions. Surgeons should be aware of their body's position during surgery, recognizing non-optimal ergonomic postures and making small modifications to instrument handling to reduce strain.

A significant take-home message for practicing urologists is the importance of partnering with the industry and involving more women in instrument design and post-marketing evaluation. This is crucial because the workforce is evolving, and instruments need to be designed to accommodate a diverse range of anthropometric indices, particularly for women who may experience higher discomfort and retire earlier due to current instrument limitations.

REFERENCE

1. Razavi S, Udedeibia E, Chrouser KL, et al. Urologist's fatigue and discomfort in different body regions after performing flexible ureteroscopy. Urology. 2025 Apr 4:S0090-4295(25)00314-0. doi:10.1016/j.urology.2025.04.004