Even as the number of women entering male-dominated surgical specialties is growing, some barriers remain. Equipment is a commonly overlooked example. The limited availability of surgical instruments designed with women in mind has significant implications for the well-being of surgeons.
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“Since my time as a medical student until now, I have witnessed the culture of surgery, and medicine in general, shift significantly with an increase in female surgeons as well as a more inclusive environment,” notes, Amy Park MD, Section Head of Female Pelvic Medicine & Reconstructive Surgery at Cleveland Clinic’s Ob/Gyn & Women’s Health Institute. “More attention is also being paid to the importance of work/life balance, and the well-being of the physician has become a priority.”
With increasing emphasis on inclusivity and gender equity comes awareness about barriers female surgeons face, including instrument design. Research has shown that female surgeons had more hand discomfort than their male counterparts, underscoring the need for redesigned equipment, such as laparoscopic instrument handles.
“The data surrounding gender and musculoskeletal disorders is tied to smaller glove size, shorter stature and instruments not being tailored to these features,” says Dr. Park. “This creates significantly more tension and strain.
“For instance, I have been operating laparoscopically more frequently, and my thenar eminence — where my thumb connects to my hand — and forearm are extremely sore,” she says. “This discomfort stems from the force required to close the handle. Due to the size of my hand, I cannot extend it enough to generate the force to easily operate the tool.
Dr. Parks adds that when she first started operating as an attending physician, she developed significant shoulder pain from retracting vaginally and had to do physical therapy to rehabilitate her shoulder. “It was a wakeup call to be mindful of my positioning,” she says.
Addressing these issues requires several approaches, including partnering with industry to bring awareness to the importance of surgical ergonomics. “We must continue to educate all stakeholders,” says Dr. Park. “The more we talk about this issue, the more our community will understand the significance of this problem.”
Personal experiences are a powerful way to grow awareness. Dr. Park recalls the impact of reading about how lead gowns that are used to protect surgeons from radiation during procedures don’t protect breast tissue near the armpits. “This is something we should be talking about,” she says. “Just as we have different clothing sizes, there should be more options available that fit the needs of different bodies.”
Dr. Park believes that institutions should be investing in equipment that can be adapted to the individual surgeon, including adjustable tables and monitors.
“Institutions have a vested interest in the health and career longevity of their surgeons, and that, in turn, has an impact on patient care. Healthcare institutions can push industry to embrace change,” Dr. Park says. “Pressure from institutions, as well as surgeons and national societies, can make a real difference.”
More research also is needed to better understand the scope of the problem, including connections between certain injuries and types of surgical procedures, Dr. Park says. “It is important to have a clear picture of the impact of this problem and how it effects health as well as career modification, burnout and disability.”
Improving gender equity and addressing barriers depends on including women in the discussion. “We need more women at the table at both the institutional and industry level who can advocate for these changes,” says Dr. Park.
Dr. Park is optimistic for the future of women in surgery.
“We are moving in the right direction and I continue to see positive shifts,” she says. “The idea that women have to conform to a male standard is slowly changing as well. The culture is evolving, and that momentum will continue as more and more women enter the surgical field and make their voices heard.”