Gofrit et al.(5) reported also hand, wrist and finger pain due to hand assisted laparoscopy.

Only few
studies were done among urologists (3, 5) and little is known about the physical well-being of urologists
practicing endourology. Moreover, with the rapid development of new minimal invasive techniques, it is
of major importance to increase awareness of ergonomic guidelines, for example in training programs,
and thus prevent the occurrence of musculoskeletal problems at an early stage. The science of
ergonomics, analyses these challenges and formulates guidelines for creating a work environment that is
safe for the surgeon and the operating team. Ergonomics is defined as “the scientific discipline
concerned with the understanding of interactions among humans and other elements of a system, and
the profession that applies theory, principles, data and methods to design in order to optimize human
well-being and overall system performance” (www.iea.cc). However, awareness of these ergonomic
guidelines among surgeons is still marginal (10). Wauben et al. (10) administered a survey among
surgeons in Europe, including general surgeons, gynaecologists 2 Page 3 of 22 Journal of Endourology
Ergonomics in Endourology and Laparoscopy: An overview of musculoskeletal problems in urology (doi:
10.1089/end.2013.0654) This article has been peer-reviewed and accepted for publication, but has yet
to undergo copyediting and proof correction. The final published version may differ from this proof. 3
and urologists, and reported that only 11% of the responders were aware of the ergonomic guidelines. In
this study we investigated the following research questions: 1) If urologists report musculoskeletal
complaints, what type and frequency are most common? 2) To what extent do urologists consider their
knowledge about ergonomic conditions during minimal invasive urology? 3). What is the preferred
method of gaining knowledge about ergonomics according to the opinion of urologists?