Advancing Ergonomics in Minimally Invasive Bariatric Surgery: a Proposed Unified Ergonomic Checklist for Minimally Invasive Surgeries in Obesity (UEC‑MISO)

Obesity is a global health challenge, and minimally invasive surgery (MIS) has become a cornerstone of its management. While MIS offers patients faster recovery and reduced postoperative pain, it imposes significant physical and cognitive demands on surgeons. Prolonged non-neutral postures, constrained visual–manual coordination, and heightened mental workload contribute to work-related musculoskeletal disorders (WRMSDs) and burnout.

WRMSDs encompass a wide range of conditions, including cervical disc degeneration, thoracic outlet syndrome, carpal tunnel syndrome, and chronic back and neck pain.
For example, prevalence estimates are striking in MBS: up to 66% of surgeons report persistent pain or physical discomfort attributed to their operative work, and approximately 27% experience symptoms severe enough to consider altering or limiting their surgical practice. Moreover, cognitive stressors, including prolonged concentration, complex decision-making, and high-stakes outcomes, contribute to mental fatigue and elevate the risk of occupational burnout.

Addressing these ergonomic risks is essential for sustaining surgical performance and career longevity, yet no standardized framework exists for metabolic and bariatric surgeries (MBS). Here, we propose the Unified Ergonomic Checklist for Minimally Invasive Surgeries in Obesity (UEC-MISO) as a preliminary, multidimensional tool to guide assessment and improvement of surgeon ergonomics.