The impact of the Alexander Technique on improving posture and surgical ergonomics during minimally invasive surgery: pilot study

J Urol. 2011 Oct;186(4 Suppl):1658-62. Epub 2011 Aug 19

Reddy PP, Reddy TP, Roig-Francoli J, Cone L, Sivan B, Defoor WR, Gaitonde K, Noh PH.

Division of Pediatric Urology, Cincinnati Children's Hospital, Xavier University, Department of Radiology, Shriners Hospital and Division of Urology, University of Cincinnati College of Medicine, Cincinnati, Ohio.



In this pilot study, the posture and surgical ergonomic skills of trainee surgeons were assessed before and after Alexander Technique lessons. 

Seven surgeons took a routine basic skill test in minimally invasive surgery and underwent an assessment of posture. The tests were repeated after eight Alexander Technique sessions consisting of two group sessions and six one-to-one lessons – all delivered by teachers belonging to the American Society for the Alexander Technique (which is affiliated with STAT). Compared with the test results before lessons, significant improvements were seen in postural endurance and in tests of surgical skills. 

The encouraging results of this pilot study have led to a full study being planned.




One of the main ergonomic challenges during surgical procedures is surgeon posture. There have been reports of a high number of work related injuries in laparoscopic surgeons. The Alexander technique is a process of psychophysical reeducation of the body to improve postural balance and coordination, permitting movement with minimal strain and maximum ease. We evaluated the efficacy of the Alexander technique in improving posture and surgical ergonomics during minimally invasive surgery.


We performed a prospective cohort study in which subjects served as their own controls. Informed consent was obtained. Before Alexander technique instruction/intervention subjects underwent assessment of postural coordination and basic laparoscopic skills. All subjects were educated about the Alexander technique and underwent post-instruction/intervention assessment of posture and laparoscopic skills. Subjective and objective data obtained before and after instruction/intervention were tabulated and analyzed for statistical significance.


All 7 subjects completed the study. Subjects showed improved ergonomics and improved ability to complete FLS™ as well as subjective improvement in overall posture.


The Alexander technique training program resulted in a significant improvement in posture. Improved surgical ergonomics, endurance and posture decrease surgical fatigue and the incidence of repetitive stress injuries to laparoscopic surgeons. Further studies of the influence of the Alexander technique on surgical posture, minimally invasive surgery ergonomics and open surgical techniques are warranted to explore and validate the benefits for surgeons.


Reprinted from J Urol. Oct;186(4 Suppl). Reddy PP, Reddy TP, Roig-Francoli J, et al.

The impact of the Alexander Technique on improving posture and surgical ergonomics duing minimally invasive surgery: a pilot study, 1658-62.

2011, with permission from Elsevier

Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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