Ergonomic assessment of female obstetricians and gynecologists performing laparoscopic surgery: Study of hand size and surgical instruments

Laparoscopic surgery, an emerging and popular surgical procedure particularly in obstetrics and gynecology (OB/GYN), poses new challenges to surgeons, especially female surgeons who use laparoscopic hand tools that are sometimes too large for their hands. The hypothesis of this study is that the small-handed female OB/GYNs experience more physical stress while performing laparoscopic surgery compared to the large handed OB/GYNs. The surgeon\u27s hands were measured and compared to the average size hands of females and males reported in the U.S. anthropometric literature databases on body dimensions. Hand grip and pinch strength were measured using grip and pinch dynamometers. In addition, common laparoscopic instruments were measured and photographed. A 24-question descriptive questionnaire was administrated to the six surgeons (five females and one male) to obtain general background information, including personal work experience and Musculoskeletal Disorders (MSDs) symptoms from the surgeons. Operating room assessment using Rapid Upper Limb Assessment (RULA, a standard Ergonomic Assessment tool) and photographs/video recordings of body postures and motions of OB/GYNs was performed to identify risk factors of work-related MSDs. Primary findings from this study included: 1) Small handed female OB/GYNs reported more difficulty using laparoscopic instruments; 2) The small handed female OB/GYNs experienced more physical stress according to RULA and questionnaire results while performing laparoscopic surgery compared to the large handed OB/GYNs including some female surgeons in this study; 3) Surgeons with awkward postures observed in laparoscopic surgery tended to report more Musculoskeletal Disorder symptoms; 4) Awkward postures tended to be more prevalent among smaller OB/GYNs, as a function of surgical workstation layout and laparoscopic hand tools