NekSpine for Thoracic Surgery

Postural Demands in Open and Minimally Invasive Chest Procedures

Thoracic surgeons operate across a procedural range spanning open thoracotomy, video-assisted thoracoscopic surgery (VATS), robotic thoracic approaches, and complex esophageal cases—each with a distinct postural profile but a consistent pattern of sustained cervical and lumbar loading. Open cases require sustained forward flexion over a deep and relatively narrow operative field. Minimally invasive cases shift the postural burden to monitor and console dependence with the same static cervical load in a different configuration. Surgeons who perform both open and minimally invasive thoracic cases across a clinical week carry a combined postural load that accumulates across multiple exposure patterns. The peer-reviewed evidence on intraoperative postural strain applies to thoracic surgeons across this full procedural range. Contact NekSpine to schedule a free trial or discuss the device for your thoracic practice, or review the clinical evidence on our clinical evidence page. Individual results will vary.

The Ergonomic Profile of Open Thoracotomy

Open thoracotomy requires the surgeon to work through a chest wall opening in a relatively fixed position, sustaining forward head flexion over an operative field that is both deep and constrained. The surgeon’s ability to reposition relative to the field is limited by the chest wall exposure, which means the postural demands of the approach are sustained rather than intermittent. Thoracic oncology cases, including lobectomy, pneumonectomy, and chest wall resection, can run three to six hours with sustained postural demands throughout the case. Hansraj KK, Surg Technol Int, 2014 documented that forward head tilt of forty-five degrees generates a reported forty-nine pounds of effective load on the cervical spine, a load pattern that open thoracic cases sustain across procedures of this length. 

VATS and Robotic Thoracic Surgery

Video-assisted thoracoscopic surgery (VATS) and robotic thoracic surgery shift the postural profile to monitor and console dependence, respectively. In VATS cases, the surgeon operates while oriented toward a monitor display, sustaining cervical flexion toward the screen across case durations that may extend two to four hours for complex resections. In robotic thoracic cases, the surgeon works at the console in the same static cervical flexion posture documented across other robotic specialties. The thoracic application of robotic surgery carries the same console ergonomic profile as robotic prostatectomy, colectomy, or hysterectomy — sustained neck flexion toward the console display, static trunk posture, and minimal positional variation during docking and operative phases. The peer-reviewed evidence that applies to surgical ergonomics generally applies to thoracic surgeons in these configurations. The NekSpine Mayo Clinic study, Annals of Surgery, 2025, evaluated NekSpine across six surgical specialties and reported a fifty-six percent increase in static endurance time and a ninety-one point seven percent device acceptance rate. Individual results will vary.

Esophageal Surgery

Esophageal surgery represents some of the more postural-demanding cases in thoracic and general surgery, combining significant abdominal and thoracic exposure components that require sustained positioning across a large operative field for cases that may extend four to eight hours or more. The combined thoracic and abdominal exposure in esophagectomy produces a postural demand that spans multiple operative phases, each with its own cervical and lumbar loading pattern. For surgeons who perform esophageal cases regularly, the cumulative postural load across a clinical week reflects both the case duration and the operative complexity that these procedures involve.

The Combined Thoracic and Cardiac Load for Surgeons Who Perform Both

Surgeons who perform both thoracic and cardiac cases carry a combined postural load across their full operative week that spans the open chest, the minimally invasive thoracoscopic, and the robotic console profiles. Each exposure pattern contributes to the cumulative cervical and lumbar load that the surgeon’s body manages across a week of operative work. According to Gorce & Jacquier-Bret, International Journal of Environmental Research and Public Health, 2023, MSDs are among the leading occupational health concerns in the surgical workforce worldwide — a pattern that a mixed thoracic and cardiac operative schedule contributes to across multiple distinct exposure types.  Learn more about cardiothoracic ergonomics on our cardiothoracic solutions page.

How NekSpine Applies to Thoracic Surgery

NekSpine’s three-component system—a lumbar vest, carbon fiber support beam, and adjustable head frame—addresses the cervical, thoracic, and lumbar load that sustained surgical positioning creates. The device weighs under two pounds, is MRI-compatible, and is compatible with loupes, headlights, and other surgical accessories. For thoracic surgeons, the device applies across open, VATS, and robotic cases—it is not specialty-specific in its mechanical function. The University of Alberta / EWI Works, Sensors, 2026 evaluated NekSpine at flexion angles of fifteen, thirty, forty-five, and sixty degrees and reported up to a thirty-one percent reduction in neck muscle activity and up to a fifty percent reduction in perceived neck discomfort. Individual results will vary. An independent trial reported a 56% increase in static posture endurance and a 91.7% surgeon acceptance rate. Schedule a free trial to evaluate the device across your own thoracic case mix.

Thoracic Surgery Places Sustained Postural Demands That Accumulate Across a Career

The peer-reviewed evidence for NekSpine — the Mayo Clinic Annals of Surgery study and the University of Alberta Sensors study — establishes outcomes during surgical and simulated procedural tasks generally, not specifically in thoracic surgery. Whether the device is effective across thoracic case types is a question best answered through the individual free trial rather than extrapolated from general surgical findings. For thoracic surgeons who want to evaluate the device in their own cases, the free trial is the starting point. For institutions evaluating NekSpine for a thoracic surgery department, the hospital pilot execution kit provides the framework.  Contact NekSpine to schedule a free trial or request the pilot kit, or review the full clinical evidence on our clinical evidence page.