{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:55:41Z","timestamp":1788494141307,"version":"build-2803163510"},"reference-count":20,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100007338","name":"All-India Institute of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007338","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["americanjournalofsurgery.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Surgery"],"published-print":{"date-parts":[[2025,9]]},"DOI":"10.1016\/j.amjsurg.2025.116517","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T07:50:43Z","timestamp":1752565843000},"page":"116517","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"special_numbering":"C","title":["Structured muscle-strengthening exercise program and intraoperative targeted stretch micro-breaks: A work in cohesion to improve surgeon ergonomics during open thyroidectomy and modified radical mastectomy"],"prefix":"10.1016","volume":"247","author":[{"given":"Hari K.","family":"Rathee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jidin","family":"Joy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhijith K.","family":"Anil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2467-7238","authenticated-orcid":false,"family":"Suhani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohit","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brijesh","family":"kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemanga K.","family":"Bhattacharjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maroof A.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yashdeep","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok K.","family":"Jaryal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajinder","family":"Parshad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.amjsurg.2025.116517_bib1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/SPV.0000000000000456","article-title":"Ergonomics in surgery: a review","volume":"24","author":"Catanzarite","year":"2018","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"2","key":"10.1016\/j.amjsurg.2025.116517_bib2","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2017.4947","article-title":"Prevalence of work-related musculoskeletal disorders among surgeons and interventionalists: a systematic review and meta-analysis","volume":"153","author":"Epstein","year":"2018","journal-title":"JAMA Surg"},{"issue":"11","key":"10.1016\/j.amjsurg.2025.116517_bib3","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1007\/s00268-008-9707-5","article-title":"Comparison between open and laparoscopic repair of perforated peptic ulcer disease","volume":"32","author":"Bhogal","year":"2008","journal-title":"World J Surg"},{"issue":"2","key":"10.1016\/j.amjsurg.2025.116517_bib4","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3109\/13645701003643972","article-title":"The operation room as a hostile environment for surgeons: physical complaints during and after laparoscopy","volume":"19","author":"Sari","year":"2010","journal-title":"Minim Invasive Ther Allied Technol"},{"issue":"1 Pt B","key":"10.1016\/j.amjsurg.2025.116517_bib5","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.amjsurg.2021.11.026","article-title":"Endocrine surgeons have high rates of work-related musculoskeletal (MSK) injury and symptoms","volume":"224","author":"Jensen","year":"2022","journal-title":"Am J Surg"},{"issue":"9","key":"10.1016\/j.amjsurg.2025.116517_bib6","doi-asserted-by":"crossref","first-page":"2538","DOI":"10.1245\/s10434-011-1628-0","article-title":"Multicenter study of robotic thyroidectomy: short-term postoperative outcomes and surgeon ergonomic considerations","volume":"18","author":"Lee","year":"2011","journal-title":"Ann Surg Oncol"},{"issue":"3","key":"10.1016\/j.amjsurg.2025.116517_bib7","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.jamcollsurg.2009.10.017","article-title":"Patients benefit while surgeons suffer: an impending epidemic","volume":"210","author":"Park","year":"2010","journal-title":"J Am Coll Surg [Internet]"},{"key":"10.1016\/j.amjsurg.2025.116517_bib8","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.apergo.2016.12.006","article-title":"The impact of intraoperative microbreaks with exercises on surgeons: a multi-center cohort study","volume":"60","author":"Hallbeck","year":"2017","journal-title":"Appl Ergon"},{"issue":"10","key":"10.1016\/j.amjsurg.2025.116517_bib9","doi-asserted-by":"crossref","first-page":"3216","DOI":"10.1245\/s10434-019-07550-1","article-title":"The \"nipple whipple\"?! A pilot study to assess the ergonomic effects of nipple-sparing mastectomy","volume":"26","author":"Kopkash","year":"2019","journal-title":"Ann Surg Oncol"},{"issue":"6","key":"10.1016\/j.amjsurg.2025.116517_bib10","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.surg.2012.08.029","article-title":"Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical thyroidectomy: a cost analysis","volume":"152","author":"Cabot","year":"2012","journal-title":"Surgery"},{"issue":"5","key":"10.1016\/j.amjsurg.2025.116517_bib11","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1007\/PL00009635","article-title":"Ergonomic problems associated with laparoscopic surgery","volume":"13","author":"Berguer","year":"1999","journal-title":"Surg Endosc"},{"issue":"2","key":"10.1016\/j.amjsurg.2025.116517_bib12","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/S1050-6411(02)00066-4","article-title":"Continuous, intermitted and sporadic motor unit activity in the trapezius muscle during prolonged computer work","volume":"13","author":"Zennaro","year":"2003","journal-title":"J ElectromyogrKinesiol Off J Int Soc Electrophysiol Kinesiol"},{"issue":"9","key":"10.1016\/j.amjsurg.2025.116517_bib13","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1007\/s00268-011-1141-4","article-title":"Development and validation of a surgical workload measure: the surgery task load index (SURG-TLX)","volume":"35","author":"Wilson","year":"2011","journal-title":"World J Surg"},{"issue":"10","key":"10.1016\/j.amjsurg.2025.116517_bib14","doi-asserted-by":"crossref","first-page":"5698","DOI":"10.1245\/s10434-021-10447-7","article-title":"Improving the breast surgeon's ergonomic workload for nipple-sparing mastectomies using exercise and operating room positioning protocol","volume":"28","author":"Kopkash","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.amjsurg.2025.116517_bib15","unstructured":"16 May 2025 at https:\/\/mcforms.mayo.edu\/mc7000-mc7099\/mc7088-33.pdf."},{"issue":"7","key":"10.1016\/j.amjsurg.2025.116517_bib16","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1007\/s00464-009-0834-3","article-title":"A study of surgeons' postural muscle activity during open, laparoscopic, and endovascular surgery","volume":"24","author":"Szeto","year":"2010","journal-title":"Surg Endosc"},{"issue":"2","key":"10.1016\/j.amjsurg.2025.116517_bib17","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.jelekin.2009.01.008","article-title":"Interpretation of EMG integral or RMS and estimates of \u201cneuromuscular efficiency\u201d can be misleading in fatiguing contraction","volume":"20","author":"Arabadzhiev","year":"2010","journal-title":"J Electromyogr Kinesiol"},{"issue":"6","key":"10.1016\/j.amjsurg.2025.116517_bib18","doi-asserted-by":"crossref","DOI":"10.1016\/j.amjoto.2022.103594","article-title":"Intraoperative stretching microbreaks reduce surgery-related musculoskeletal pain in otolaryngologists","volume":"43","author":"Elzomor","year":"2022","journal-title":"Am J Otolaryngol"},{"issue":"4","key":"10.1016\/j.amjsurg.2025.116517_bib19","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1007\/s00464-010-1350-1","article-title":"Effects of intraoperative breaks on mental and somatic operator fatigue: a randomized clinical trial","volume":"25","author":"Engelmann","year":"2011","journal-title":"Surg Endosc"},{"issue":"2","key":"10.1016\/j.amjsurg.2025.116517_bib20","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/SLA.0000000000001665","article-title":"Intraoperative \u201cmicro breaks\u201d with targeted stretching enhance surgeon physical function and mental focus: a multicenter cohort study","volume":"265","author":"Park","year":"2017","journal-title":"Ann Surg"}],"container-title":["The American Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S000296102500340X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S000296102500340X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T11:14:45Z","timestamp":1762082085000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S000296102500340X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":20,"alternative-id":["S000296102500340X"],"URL":"https:\/\/doi.org\/10.1016\/j.amjsurg.2025.116517","relation":{},"ISSN":["0002-9610"],"issn-type":[{"value":"0002-9610","type":"print"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Structured muscle-strengthening exercise program and intraoperative targeted stretch micro-breaks: A work in cohesion to improve surgeon ergonomics during open thyroidectomy and modified radical mastectomy","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.amjsurg.2025.116517","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"116517"}}