Intraoperative Fluoroscopy Exposure: A Systematic, Multi-specialty Review of Occupational Radiation Exposure to Surgeons.

Fluoroscopy is commonly used intraoperatively to obtain real-time procedural imaging. While this technique is integral for patient care, it increases the exposure of surgeons and staff to ionizing radiation. To date, no comprehensive systematic review has examined the radiation risks associated with fluoroscopy or the protective strategies implemented across surgical subspecialties. Following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, we searched PubMed and EMBASE to identify studies reporting surgeons' intraoperative occupational radiation exposure and related health outcomes due to fluoroscopy use. Of the 1,235 articles initially screened, 71 met the inclusion criteria and were subsequently grouped into six common themes: review articles (13/71, 18.3%), radiation exposure (13/71, 18.3%), radiation reduction techniques (other than shielding) (15/71, 21.1%), radiation shielding (9/71, 12.7%), cancer prevalence/risk (12/71, 16.9%), and guideline awareness and adherence (9/71, 12.7%). Given the hazards of ionizing radiation, surgeons must understand the levels of exposure, associated risks, and preventive strategies when using intraoperative fluoroscopy. This multispecialty review synthesizes the current literature on occupational fluoroscopic radiation exposure and provides surgeons with the guidance needed to perform these procedures safely.