A Woman’s Place Is in Theatre, but Are Theatres Designed with Women in Mind? A Systematic Review of Ergonomics for Women in Surgery
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Work-Related Physical Discomfort
3.2. Compliance of Surgical Devices with Female Requirements
3.3. Impact on Training, Productivity, and Career Longevity
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author | Selection | Comparability | Outcome | Total |
---|---|---|---|---|
Adams et al. [13] | 2 | 2 | ||
Aitchison et al. [14] | 3 | 1 | 4 | |
Armijo et al. [15] | 3 | 1 | 4 | |
Berguer et al. [10] | 2 | 2 | ||
Cavanagh et al. [16] | 2 | 2 | ||
Dalsgaard et al. [17] | 3 | 1 | 4 | |
Gonzalez et al. [18] | 3 | 1 | 4 | |
Harutunian et al. [19] | 2 | 2 | ||
Hokenstad et al. [20] | 3 | 1 | 4 | |
Jensen et al. [21] | 2 | 2 | ||
Kono et al. (2012) [22] | 2 | 2 | ||
Kono et al. (2014) [9] | 3 | 1 | 4 | |
McQuivey et al. [23] | 2 | 2 | ||
Stewart et al. [24] | 2 | 2 | ||
Sutton et al. [8] | 2 | 2 |
Study | Specialty | Country | Method | Percentage of Female Participants (Female/Total Participants) | Findings |
---|---|---|---|---|---|
Adams et al. [13] | Gynaecology | USA | 19-item survey on demographics, surgical practice patterns, physical symptom duration, and effect on work or leisure activities | 49.7% (246/495) | Musculoskeletal symptoms are highly prevalent, and female sex is associated with an approximately twofold risk of reported pain in the lower back region (p = 0.02), in the upper back (p = 0.002), and in the wrist/hand region (p = 0.001) |
Aitchison et al. [14] | Gynaecology | Australia | Observational: video recordings of 18 surgeons | 83.3% (15/18) | Shorter surgeons maintain significantly greater degrees of neck rotation when looking at the monitor (p < 0.003). Surgeons with shorter arm lengths spend longer time in extreme positions with their non-dominant shoulder at >90° (p = 0.04) and elbow at >120° (p < 0.001) |
Armijo et al. [15] | General surgery | USA | Observational: evaluation of muscle group activation during surgery via electromyography | 44.4% (8/18) | Increase in muscle activation is observed for female laparoscopic surgeons (p < 0.001). Self-perceived sensory (p = 0.026) and cognitive (p = 0.045) fatigue scores are higher among female surgeons at the end of the surgery. |
Berguer et al. [10] | General surgery | USA | Online survey on demographic and practice data, musculoskeletal symptoms, and the perceived difficulty in using several types of laparoscopic instruments | 21.9% (159/726) | Hand size is a significant determinant of difficulty using laparoscopic surgical instruments, particularly for sizes 6.5 or smaller (p < 0.001) |
Cavanagh et al. [16] | Otorhinolaryngology | USA | 28-item online survey on demographics, surgical practice characteristics, physical symptoms, and ergonomics | 15.0% (15/100) | Female surgeons report higher experience of pain/discomfort associated with their surgical practice (p = 0.033) |
Dalsgaard et al. [17] | Gynaecology | Denmark | Observational (semi-randomised): bipolar surface electromyogram; calculation of gaps per minute plus static and peak muscle activation were calculated during surgeries | 58.3% (7/12) | Neck and static shoulder muscle activities are lower in robotic surgery compared to laparoscopy (p < 0.05) |
Gonzalez et al. [18] | General surgery | Spain | Observational: Trial to determine the optimal diameter of the handle from an ergonomic point of view | 51.1% (69/135) | The optimal diameter of the instrument’s handle differs according to the hand size, especially for smaller hands (p < 0.05) |
Harutunian et al. [19] | Dentistry | Spain | 19-item survey on demographics and questions regarding ergonomics of the instrument holder and resulting musculoskeletal disorders | 52.7% (39/74) | Most of the dentists experience musculoskeletal pain, and women show a higher frequency of intense pain (p < 0.05) |
Hokenstad et al. [20] | Gynaecology | USA | Inertial measurement and survey before and after ergonomic implementation during robotic hysterectomy | 50.0% (3/6) | Improved objective surgeon posture at the console when compared with the surgeons’ self-selected settings: neck (p = 0 .008) and right upper arm (p = 0.02) |
Jensen et al. [21] | Endocrine surgery | USA | 43-item online survey on demographics, surgical information, prevalence of musculoskeletal symptoms, and pursued therapy/treatment; ergonomic recommendations | 32.9% (72/220) | Women more likely to report pain and stiffness after surgery (p = 0.004). Most common locations are the neck and shoulder |
Kono et al. (2012) [22] | General surgery | Japan | 9-item online survey on demographics and questions regarding circular and linear staplers | 30.4% (74/243) | Surgeons with small glove sizes express a low satisfaction level regarding the anastomotic staplers (p < 0.0001), suggesting a need to develop instruments whose usability is not affected by different hand sizes and lengths of fingers |
Kono et al. (2014) [9] | General surgery | Japan | Observational: evaluation of the relationship between grip width and the operation force required to push the lever of the stapler | 53.7% (61/113) | Men have wider optimal grip width than women for both the dominant and non-dominant hands (p < 0.001) |
McQuivey et al. [23] | Orthopaedics | USA | Online survey on demographics, symptoms by body part, and attitudes/beliefs/behaviours regarding surgical ergonomics | 27.6% (21/76) | No sex-specific differences, but concerns about implications for work satisfaction (p = 0.005), burnout (b = 0.04), and callousness toward others (p < 0.0001) |
Stewart et al. [24] | General surgery | USA | Survey on demographics, the surgery performed, intraoperative ergonomics, and task load during surgery | 28.2% (24/85) | Short surgeons and male surgeons report more pain after both open and robotic operations (p < 0.001). |
Sutton et al. [8] | General surgery | USA | 23-item online survey on demographics, physical symptoms, ergonomics, and environment/equipment | 17.2 % (54/314) | Female surgeons experience more treatment for their hands (p = 0.028). Women with a size 5.5–6.5 surgical glove report discomfort in their shoulder area more commonly than men with the same surgical glove size (p = 0.004). |
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Bellini, M.I.; Amabile, M.I.; Saullo, P.; Zorzetti, N.; Testini, M.; Caronna, R.; D’Andrea, V. A Woman’s Place Is in Theatre, but Are Theatres Designed with Women in Mind? A Systematic Review of Ergonomics for Women in Surgery. J. Clin. Med. 2022, 11, 3496. https://doi.org/10.3390/jcm11123496
Bellini MI, Amabile MI, Saullo P, Zorzetti N, Testini M, Caronna R, D’Andrea V. A Woman’s Place Is in Theatre, but Are Theatres Designed with Women in Mind? A Systematic Review of Ergonomics for Women in Surgery. Journal of Clinical Medicine. 2022; 11(12):3496. https://doi.org/10.3390/jcm11123496
Chicago/Turabian StyleBellini, Maria Irene, Maria Ida Amabile, Paolina Saullo, Noemi Zorzetti, Mario Testini, Roberto Caronna, and Vito D’Andrea. 2022. "A Woman’s Place Is in Theatre, but Are Theatres Designed with Women in Mind? A Systematic Review of Ergonomics for Women in Surgery" Journal of Clinical Medicine 11, no. 12: 3496. https://doi.org/10.3390/jcm11123496
APA StyleBellini, M. I., Amabile, M. I., Saullo, P., Zorzetti, N., Testini, M., Caronna, R., & D’Andrea, V. (2022). A Woman’s Place Is in Theatre, but Are Theatres Designed with Women in Mind? A Systematic Review of Ergonomics for Women in Surgery. Journal of Clinical Medicine, 11(12), 3496. https://doi.org/10.3390/jcm11123496