Q&A: Appropriately sized instruments needed for female surgeons

Key takeaways:

• Lara Devgan, MD, MPH, FACS, discussed the issue of surgical instrument size for female surgeons.
• Most female surgeons report discomfort and difficulty handling surgical tools.

The lack of surgical instruments tailored for women’s hands is just one example of the gender inequity female surgeons face in the workforce.

Despite women comprising 36% of physicians currently working in the medical field, surgical instruments have long been standardized for men’s hands. As a result, 70% to 85% of female surgeons report discomfort and difficulty handling these instruments, according to a recent publication by Lara Devgan, MD, MPH, FACS.

The lack of surgical instruments sized for women has affected those in the dermatology and cosmetic fields as well, and as the medical field grows more diverse, the need for surgical instruments that accommodate the sizes and shapes of women’s hands is imperative.

Lara Devgan, MD, MPH

To raise awareness of this issue, Healio spoke with Devgan, an attending plastic surgeon at Lenox Hill Hospital, Greenwich Hospital and Manhattan Eye, Ear & Throat Infirmary, chief medical officer of RealSelf and CEO of Dr. Devgan Scientific Beauty, which created a line of plastic surgery instruments for women.

Healio: What is the current gender diversity landscape among physicians and surgeons in your field?

Devgan: The landscape of gender diversity in plastic and reconstructive surgery has been evolving, with an increasing number of women entering the field. Historically, surgery has been a male-dominated specialty, but recent years have seen a rise in female surgeons. Women now make up a small but growing percentage of the plastic surgery workforce, as more women are choosing to specialize in this field. Despite the progress, challenges remain, such as gender biases, fewer leadership roles for women and work-life balance issues.

Healio: Are all surgical instruments standardized for men’s hands?

Devgan: Traditionally, most surgical instruments have been designed based on the average male hand size, which can be a disadvantage for female surgeons whose hands are generally smaller. My line of instruments is among the first to be specifically designed for women, taking into account the ergonomics and comfort needed for smaller hands to improve precision and reduce fatigue during surgeries.

Healio: Why are surgical instruments standardized for men’s hand sizes?

Devgan: Surgical instruments were standardized for male hand sizes historically because the majority of surgeons were men when these tools were initially developed. This legacy has continued despite the growing number of female surgeons. The lack of diversity in the design process has resulted in instruments that may not be optimal for all users.

Healio: How does the lack of surgical instruments for women affect physicians and their patients?

Devgan: The lack of appropriately sized instruments for female surgeons can lead to discomfort, increased fatigue and a higher risk for musculoskeletal injuries for surgeons with smaller hands. This can impact a surgeon’s ability to perform procedures efficiently and comfortably. For patients, this might translate into longer surgery times during procedures. Smaller, more delicate surgical instruments also translate into the ability to create more meticulous and refined endpoints, and this is a key feature in thinking about this concept.

Healio: How will new instruments for women benefit patients and make a change in the plastic surgery field?

Devgan: New instruments designed for surgeons with smaller hands will improve the ergonomics and comfort for female surgeons, allowing them to perform surgeries with greater precision and less fatigue. This can lead to better outcomes for patients, including shorter surgery times, reduced complication rates and improved overall care.

Additionally, these advancements can encourage more women to enter and thrive in the field of plastic surgery, promoting greater gender diversity and equity. Limitations in ease of use of instruments is one of many small examples of structural bias in the field of surgery.

Healio: What is your hope for the future of gender equity in this field?

Devgan: My hope for the future of gender equity in plastic surgery is that we continue to see an increase in the number of women entering and leading in this field. By addressing the unique needs of female surgeons, such as through the development of tailored instruments, we can create a more inclusive and supportive environment. This, in turn, can lead to better patient care, more innovative surgical practices and a more diverse and dynamic field overall.

Healio: How can surgical instruments better cater to the ergonomic needs of women who are surgeons?

Devgan: These instruments feature smaller handles, lightweight materials and enhanced grip designs to reduce hand fatigue and improve precision during procedures. The goal is to provide female surgeons with tools that are as comfortable and effective as those designed for their male counterparts, ultimately enhancing their surgical performance and patient outcomes. Ideally, this concept could be translated across a variety of surgical fields and instrument types. Instrument designers and companies should strive to create a wider range of types of instruments in collaboration with hospital systems as well.

Healio: Is there anything else you would like to add?

Devgan: I would like to emphasize the importance of ongoing research and development in creating inclusive tools and environments in the medical field. It is not just about creating instruments for female surgeons but also about fostering a culture that values and supports diversity in all its forms. By doing so, we can ensure that the field of plastic surgery continues to evolve and innovate, providing the best possible care for all patients.

For more information: Devgan can be reached at lara@laradevganmd.com.

Reference:

• Does one size fit all? Gender equity and the impact of surgical instrument size on ease of use for female surgeons: A systematic review. https://www.researchgate.net/publication/381399982_Does_One_Size_Fit_All_Gender_Equity_and_the_Impact_of_Surgical_Instrument_Size_on_Female_Surgeons_A_Systematic_Review_Does_One_Size_Fit_All_Gender_Equity_and_the_Impact_of_Surgical_Instrument_Size_on_. Published June 2024. Accessed Aug. 12, 2024.