Occupational Strain in Vascular Surgery: A Narrative Review of Musculoskeletal and Physiological Stress and Its Mitigation.

OBJECTIVE: Vascular surgery imposes substantial physical and psychological demands, with up to 78% of surgeons reporting work-related musculoskeletal pain and 41% experiencing symptoms of burnout. Prolonged lead-apron use, static operative postures, high-stress emergency cases, and irregular schedules compound these risks, yet few wellness frameworks are tailored specifically to this specialty. METHODS: We performed a focused review of the literature on surgeon musculoskeletal discomfort, stress biomarkers (cortisol), and burnout, and synthesized data from national surveys - such as the Society for Vascular Surgery Wellness Task Force; n = 872 - alongside controlled studies of exercise and mindfulness interventions. We synthesized this evidence as a focused narrative review centered on the occupational strain most specific to vascular surgery: work-related musculoskeletal injury and the physiological stress of emergency cases. RESULTS: Brief, thrice-daily stretching routines have been shown to reduce self-reported musculoskeletal pain by up to 35%, and intraoperative micro-breaks reduce muscle fatigue without prolonging operative time. Emergency cases are associated with significantly greater cortisol elevations than elective cases, persisting for up to 24 hours postoperatively, and with a 62% greater autonomic stress response. Evidence from adjacent high-stakes fields suggests that brief breathing and cognitive-pause techniques may improve stress physiology and reduce technical errors, though direct vascular-surgery data are lacking. CONCLUSIONS: This narrative review synthesizes the available evidence on occupational strain specific to vascular surgery, focusing on work-related musculoskeletal injury and the physiological stress of emergency cases. The evidence supports targeted ergonomic and stress-mitigation strategies and identifies clear gaps for future specialty-specific study, with the ultimate aims of preserving surgeon well-being and patient care.