Investigation of the association between the sex of the surgeon and the ergonomic constraint of the laparoscopic device in gynecological surgery

Goal of the study

To assess whether female versus male gender is associated with greater ergonomic strain with the use of 4 advanced energy laparoscopic devices (LigaSure, HALO PKS, ENSEAL, and Harmonic Scalpel).


Online survey distributed by e-mail via the REDCap platform. All responses were anonymous.


United States National Survey.


Gynecological surgeons were interviewed through the Society of Gynecologic Surgeons mailing list and 4 departmental obstetrics and gynecology mailing lists.


The survey was distributed between 5/01/2020 and 11/01/2020.

The primary endpoint was the presence of physical complaints due to laparoscopic devices. Descriptive statistics compared surgeon characteristics and ergonomic symptoms. A logistic regression was performed, adjusted for the characteristics of the surgeon.

Measures and main results

The response rate was 39%, including 149 women (78%) and 41 men (22%). Women compared to men had a significantly younger age (mean 34 vs 44, p 10 years (19% versus 49%, p


Women significantly more often report physical complaints and improper fit of the LigaSure, HALO PKS, ENSEAL and Harmonic scalpel. Female sex is associated with a five times greater risk of physical problems when using a laparoscopic device. Further investigation of the surgeon factors underlying device stress is an essential next step in understanding and reducing surgeon ergonomic injuries.

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