**2.2 Adverse ergonomics**

The placement of trocars and limitations of the laparoscopic instruments can place surgeons in non-ergonomic positions. The arms and shoulders may be elevated, and in obese patients, the surgeon may need to lean to reach the operative field. In complex laparoscopic operations, this may prolong the operation, reduce the dexterity of the surgeon and lead to fatigue. There have been multiple reports of carpal tunnel syndrome, eye strain, and cervical spondylosis among surgeons performing multiple laparoscopic procedures in high-volume centers [8, 9].
