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One size does not fit all: Impact of hand size on ease of use of instruments for minimally invasive surgery

Green, Sophie V.; Morris, David E.; Naumann, David N.; Rhodes, Hannah L.; Burns, J. Kate; Roberts, Rebecca; Lang, Alexandra R.; Morris, Louise

One size does not fit all: Impact of hand size on ease of use of instruments for minimally invasive surgery Thumbnail


Sophie V. Green

David N. Naumann

Hannah L. Rhodes

J. Kate Burns

Rebecca Roberts

Louise Morris


Background: Consideration of ergonomic factors is important for the practice of safe and efficient minimally invasive surgery (MIS). Surgeons with smaller glove sizes have previously been reported to have increased difficulties with some minimally invasive instruments. We aim to investigate hand anthropometrics and their relationship to surgeon comfort when using MIS instruments. Methods: Male and female surgeons from two centres were surveyed on their experience of handling MIS instruments and images obtained of the dorsal and palmar aspects of their dominant hand. Photographs of hands were transformed to calibrated coordinates to enable anthropometric measurements of finger length and width as well as palm width and hand span photogrammetrically. Surgeon-perceived discomfort, fatigue, pressure points and techniques to mitigate difficulty handling instruments were compared to hand measurements. Results: Questionnaires were completed by 58 surgeons; 20 (34%) were consultants, 17 (29%) were women. Glove size ranged from 6 to 8 (median 7.5). Male participants had significantly larger hands than females in all measured dimensions. Female surgeons and those with smaller finger and hand dimensions were significantly more likely to experience difficulty or discomfort across a range of variables when using MIS instruments. Conclusions: Surgeons with smaller hands reported increased problems handling MIS instruments. This represents an issue of equity in surgery, with women being more significantly affected than men. Hand size varies greatly between surgeons and anthropometric variability should be considered in design of MIS instruments.

Journal Article Type Article
Acceptance Date Nov 3, 2022
Online Publication Date Dec 10, 2022
Publication Date 2023-10
Deposit Date Dec 7, 2022
Publicly Available Date Dec 11, 2023
Journal The Surgeon
Print ISSN 1479-666X
Electronic ISSN 2405-5840
Publisher Elsevier BV
Peer Reviewed Peer Reviewed
Volume 21
Issue 5
Pages 267-272
Keywords Surgery
Public URL
Publisher URL
Additional Information This article is maintained by: Elsevier; Article Title: One size does not fit all: Impact of hand size on ease of use of instruments for minimally invasive surgery; Journal Title: The Surgeon; CrossRef DOI link to publisher maintained version:; Content Type: article; Copyright: © 2022 The Authors. Published by Elsevier Ltd on behalf of Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland.


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