The ergonomics of women in surgery

Abstract

Among surgeons who regularly perform minimally invasive surgery, as many as 87 % report injuries or symptoms related to job performance. Operating room and instrument design have traditionally favored surgeons who are taller and who possess hands that are, in general, large and strong. We hypothesize that women may be experiencing more ergonomic difficulties than men for whom the operating room and surgical instruments, although uniformly perilous, more traditionally have accommodated. A 23-item web-based survey was offered via email to 2,000 laparoscopic surgeons and fellows currently practicing. The survey addressed four categories: demographics, physical symptoms, ergonomics, and environment/equipment. Key questions allowed us to identify which body part experienced which symptoms. There was a 15.7 % overall response rate. Among respondents, 17 % (54/314) were female. Women were significantly younger, shorter, had smaller glove size, and fewer years in practice than men surveyed (all p values < 0.0001). Of women reporting, 86.5 %—comparable to men—attribute physical discomfort to laparoscopic operating. Female surgeons are more likely to receive treatment for their hands, which includes the wrist, thumb, and fingers (odds ratio 3.5, p = 0.028). When men and women of the same glove size were compared, women with a larger glove size (7–8.5) reported more cases of treatment for their hands than men of the same glove size. (21 vs. 3 %, p = 0.016). Women who wore a size 5.5–6.5 surgical glove reported significantly more cases of discomfort in their shoulder area (neck, shoulder, upper back) than men who wore the same size surgical glove (77 vs. 27 %, p = 0.004). Women surgeons are experiencing more discomfort and treatment in their hands than male surgeons. Redesign of laparoscopic instrument handles and improvements to table height comprise the most promising solutions to these ergonomic challenges.