"This is an opportunity for surgeons to legitimize their own symptoms and have the nerve to say something so they can keep on operating longer into the future. I guarantee I'm going to start talking about it."

Other laparoscopic surgeons agree that more needs to be done to prevent injury, including Dr. Daniel B. Jones, chief of Minimally Invasive Surgical Services at Beth Israel Deaconess Medical Center in Boston and an associate professor of surgery at Harvard Medical School.

Jones said he does try to adjust equipment before surgery for his comfort, but not midsurgery, and not if the patient's needs get in the way. He also tries to stretch between surgeries and get enough rest, but that sometimes gives way to his schedule.

Parts wear down
And if he has pain, the only one likely to hear about it is his wife, because "there's no glory in admitting you have a sore neck."

Still, Jones said, "We've got to remember that even if we were made out of steel, parts used over and over again are going to wear down."

He noted operations are frequently six hours or longer and he sometimes does several in a day. He said he knows many surgeons who have needed neck surgery. At 45, he's trying to avoid that fate by paying more attention to his position and equipment.

At the same time, those who make and maintain that equipment are trying to improve on the technology.

Tables, monitors and surgical devices have become more flexible, but manufacturers can only improve on them when they know what's wrong, said Robert Bain, president of the Baltimore Medical Engineers and Technicians Society, whose members repair and test medical equipment.

Developing guidance for manufacturers and doctors is next for Park, who has been studying surgical ergonomics for several of his 18 years in the laparoscopic field. He'd like to lure others into helping because a lot more research is needed.

"We don't know yet what recommendation to make," said Park, who plans to use a laparoscopic training lab he developed years ago for such study.

"I'm trying to fill a void. The first step is awareness that there's a problem."


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