Ergonomic Accessibility in the Operating Room Among Obstetric and Gynecologic Surgeons

INTRODUCTION: Ergonomics is the science of humans' interactions with their working environment, particularly associated with comfort and efficiency. Surgical equipment that can enhance ergonomics includes steps, adjustable OR tables, and instruments with reduced grip force. Current data show surgeons' concern for musculoskeletal strain due to ergonomic challenges in the operating room (OR). However, there is little research on the accessibility of ergonomic instruments for primarily female surgeons. OBJECTIVE: Our primary aim was to assess how obstetric and gynecologic (Ob/Gyn) surgeons perceive the impact of ergonomics on patient and surgeon safety. Our secondary aims were to assess the need for and access to ergonomic equipment, including steps, adjustable OR tables, and comfortable laparoscopic instruments. METHODS: This is a cross-sectional survey study among members of Ob/Gyn societies (AAGL, SMFM, SGO, and SGS). The survey assesses demographic information and the need for and access to ergonomic instruments. Respondents were grouped by glove size (Small: ≤ 6, Medium: 6.5–7, and Large: ≥7.5). Unpaired t-test and one-way ANOVA with post-hoc Tuckey HSD were used for statistical analysis. To assess the responses by surgeon height, the Kruskal–Wallis test was run using the continuous variable of height. Significance was defined as p≤.05. RESULTS: There were 404 responses (300 female, 99 male, and 2 prefer not to state), primarily gynecologic oncologists (156) and minimally invasive gynecologic surgeons (185). Female surgeons reported more difficulty accessing OR lights, treatment for musculoskeletal concerns (p<.001), and impact of ergonomics on efficiency within the OR (p<.001). Surgeons with small glove sizes reported more discomfort with laparoscopic instruments (p<.001), more difficulty accessing correct glove size (p<.001), and more often noted ergonomics impacted their career satisfaction (p<.001). Surgeons of shorter height reported more difficulty accessing their correct glove size, reaching OR lights, discomfort with laparoscopic instruments, and increased need for smaller instruments (p<.001). Additionally, surgeons of shorter height reported more concern for patient (p=.008) and physician (p<.001) safety due to ergonomics in the operating room. CONCLUSIONS: Surgeons with smaller glove size and shorter stature had increased discomfort with laparoscopic instruments and difficulty accessing ergonomic equipment. Surgeons with smaller glove sizes reported the impact of ergonomics on career satisfaction. Among female surgeons and those of shorter height and smaller glove size, there is a need for improved access to ergonomic equipment. The operating experience may be unintentionally biased against surgeons of small physique, which impacts inclusivity within the operating room. Additionally, the lack of access to ergonomic instruments may result in musculoskeletal injuries and reduced career satisfaction. Therefore, to promote inclusivity, safety, and longevity within the OR, efforts should be placed on developing and distributing surgical instruments focused on the ergonomics of these surgeons (Tables 1–3).