Background: Laparoscopic surgery imposes distinctive ergonomic demands, including static postures, fulcrum-effect instrument handling, two-dimensional vision, and reduced tactile feedback, yet formal ergonomics training is rare. Methods: This narrative review synthesised evidence from systematic reviews, meta-analyses, observational studies, and intervention trials, including a meta-analysis of 21 studies involving 5,828 physicians. Results: Work-related musculoskeletal disorders affected 73–100% of laparoscopic surgeons, most commonly involving the neck (48–65%), shoulders (45–76%), and back (50%), with degenerative disc prolapse reported in 19%. Female surgeons were more frequently affected than male surgeons (57% vs. 36%), likely reflecting instrument design based on male hand dimensions. Laparoscopic instruments required up to sixfold greater grip force than open instruments. Evidence supports practical ergonomic interventions: monitor placement at a 15° gaze-down angle and 0.8–1.2 m viewing distance reduced operative time by 10%; microbreaks of 1.5–2 minutes every 40 minutes improved physical performance by 57% and mental performance by 38% without prolonging operative time; and ergonomics coaching improved symptoms in 82% of participants. Conclusion: Laparoscopic surgery carries substantial, underrecognised ergonomic risk. A multimodal response combining engineering controls, administrative strategies, and personal self-management is needed to reduce injury, preserve operative performance, and support career longevity.