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tension, which contributes to increased forearm and shoulder muscle effort. Female surgeons who often have smaller hands than their male counterparts can struggle with one-size-fits-all instrumentation, especially surgical staplers that require the application of substantial force.
PERFECT POSITION Place monitors so surgeons look at the screens head-on.
Advances in instrumentation are helping the surgeon's cause, particularly multi-functional devices and tools that require less manual output to complete common surgical tasks. For example, newer articulating staplers reduce the amount of suturing and knot tying that's required. In addition, well-designed energy delivery devices reduce cutting and clip application.
Look for instruments that allow for a more efficient transfer of force from handle to tip; handles that permit a more natural (neutral) wrist position over the range of normal working angles; designs that require less arm elevation when working at an angle to the surgeon's body; and configurations that accommodate fine- or power-grip hand positions. Switching a surgeon's preferred handle between various tools, which modular instruments allow for, might be a plus, but many instruments still have pistol-grip designs that haven't changed for decades and continue to put surgeons' wrists in awkward positions.
Surgeons should palm instruments when performing prolonged grasping, and should consider various handle shapes — pistol, axial, angled and flexible, for example — for different tasks and orientations. Foot pedals that activate various devices are widely used, but often cause
