7 Tips For Better Ergonomics in Neurosurgery

Pain and muscle tension are common phenomena in a neurosurgeon’s workday: 78 % of neurosurgeons surveyed reported pain after a day of surgery, 83 % of these had musculoskeletal pain [1]. By its nature, neurosurgery requires compromising positions. However, with a few simple steps and the right ergonomic accessories for the surgical microscope, the working environment in the OR can be made as comfortable as possible.

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Among the common causes of pain for neurosurgeons are posterior cervical or fossa procedures which can place a strain on the head, neck and arms. Long craniotomy procedures require a performance with outstretched arms. Additionally, many procedures in neurosurgery involve standing for an extended amount of time. All these compromising positions are a severe burden on the surgeon’s body. For example, for every inch the head moves forward, the head, neck, and upper back muscles must compensate to support an additional 10 pounds of weight [2]. This can cause aches and pains which may radiate down the arms, or be localized and may lead to headaches, chronic pain and further exhaustion.

Even the most experienced surgeons can only deliver the best possible results if they provide their bodies with optimum conditions. A comfortable posture, supported by a surgical microscope with ergonomic features, enables surgeons to remain focused on their highly precise work. Working in an ergonomic position could also help reduce exhaustion at the end of the day.

1. Adjust the microscope to you

Too often, surgeons accommodate themselves to fit the surgical microscope. Find your most comfortable working position by defining your "free space" zone. How do you position your hands? Where and how do you stand? How straight is your back, how tense are your shoulders? The body should be in a perpendicular line, i.e. ear, shoulder joint and hip joint have to be in vertical alignment. Find your most comfortable working position that minimizes leaning in at an awkward angle. Then re-adjust the microscope to fit you.

2. Optimize your working environment

The operating table has to be set at the right height. The correct working distance between the surgeon and the table must be observed.

3. Move the microscope stand out of your personal space

An overhead surgical microscope with a long reach and high overhead clearance allows you to position the microscope base out of your way, so that you have complete freedom of movement. With such a microscope, e.g. the Leica M530 OH6 or the Leica M720 OH5, you minimize any feeling of being cramped or confined.

4. Choose the best optics to limit eye fatigue

Premium optics can help to avoid problems like fatigue and headaches, which may occur after many hours spent looking through a microscope. An apochromatic multifocal lens and high-quality optics by Leica Microsystems provide smooth lighting, excellent depth of focus, and advanced color correction.

5. Benefit from a compact microscope head

The shorter the microscope (measured from eyepiece to objective lens), the more natural your position will be. With a compact optical head, which is offered by the surgical microscopes from Leica Microsystems, you can work in a natural, relaxed position – rather than having your arms outstretched to reach the surgical field.

6. Select the right binoculars for you

Nobody is the same and therefore every surgeon has different demands of the surgical microscope. With a large portfolio of binoculars and adapters for microsurgery, Leica Microsystems offers a solution for your individual physique. No matter the procedure, you can find the right binoculars for your body type. If you operate with an assistant, or if multiple surgeons will share a microscope, then each individual should select the binoculars that are best for him or her.

7. Create visibility for the entire OR team

Choose a large integrated HD monitor with a long and flexible monitor arm. Combined with top-of-the-line HD camera and recording, such a system allows the entire OR team to easily see the procedure. Video solutions will ensure that the entire OR team is comfortable and informed throughout the procedure. Even more impressive visualization can be achieved by using a Leica surgical microscope with integrated TrueVision 3D surgical imaging such as the Leica M530 OH6 or the Leica M720 OH5. This allows assistants, nurses and students to share the same 3D view as the surgeon via 3D screens in the OR, or even remotely.


  1. Leica Microsystems survey of 59 neurosurgeons in the USA.
  2. Kapandji A: The Physiology of the Joints, Volume 3. 6th ed. Churchill Livingstone, London, UK (2008).

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