Research Papers

Assessing the Importance of Surgeon Hand Anthropometry on the Design of Medical Devices

[+] Author and Article Information
Michael Stellon

Department of Graduate Medical Sciences,
Boston University School of Medicine,
1224 24th Street Northwest Apartment 703,
Washington, DC 20037
e-mail: michael.stellon@gmail.com

Drew Seils

Medtronic Minimally Invasive Therapies Group,
60 Middletown Avenue,
North Haven, CT 06473
e-mail: drew.r.seils@medtronic.com

Christine Mauro

Medtronic Minimally Invasive Therapies Group,
555 Long Wharf Drive,
New Haven, CT 06511
e-mail: christine.mauro@medtronic.com

1Corresponding author.

Manuscript received October 15, 2016; final manuscript received May 26, 2017; published online August 17, 2017. Assoc. Editor: Rita M. Patterson.

J. Med. Devices 11(4), 041004 (Aug 17, 2017) (6 pages) Paper No: MED-16-1340; doi: 10.1115/1.4037257 History: Received October 15, 2016; Revised May 26, 2017

Improperly designed medical devices can induce unwanted biomechanical stressors on their users, impacting health and career longevity. Despite this, manufacturers struggle to balance device design with the growing female surgeon population. We have applied anthropometry to a population of surgeon hands as an alternative to preferred glove size. Correlations to physical dimensions of two laparoscopic staplers were assessed. Five anthropometric measurements were taken from dominant hands of surgeons. These measurements were selected with the goal of comparing resulting data to published anthropometry studies and assessing correlation to preferred glove size and instrument design. The trigger reach of the two laparoscopic staplers were measured to assess suitability among the surgeon population surveyed. Fifty eight surgeons (50 male, 8 female), average glove size 7.5 and 6.0, were measured. Data indicate that male surgeons had significantly larger hands than female. Hand circumference displayed a relatively strong positive correlation with preferred glove size (0.799, R2 = 63.9%); other measurements did not. The trigger span of one stapler was found suitable for only 78.2% of male and 30.9% of female surgeons, based on comparisons with anthropometry of the surveyed population. Anthropometry should be used to characterize surgeon hands instead of preferred glove size. Also, from the limited scope of this research, discrepancies exist between the size of the surgeon hand and the devices designed for their use. The use of inappropriately designed instrumentation can cause musculoskeletal injury, decreased productivity, and shortened careers. Manufacturers would benefit by consulting anthropometry databases to develop products.

Copyright © 2017 by ASME
Your Session has timed out. Please sign back in to continue.


Sutton, E. , Irvin, M. , Zeigler, C. , Lee, G. , and Park, A. , 2014, “ The Ergonomics of Women in Surgery,” Surg. Endosc., 28(4), pp. 1051–1055. [CrossRef] [PubMed]
Berguer, R. , and Hreljac, A. , 2004, “ The Relationship Between Hand Size and Difficulty Using Surgical Instruments: A Survey of 726 Laparoscopic Surgeons,” Surg. Endosc., 18(3), pp. 508–512. [CrossRef] [PubMed]
Cohen, D. L. , Naik, J. R. , Tamariz, L. J. , and Madanick, R. D. , 2008, “ The Perception of Gastroenterology Fellows Towards the Relationship Between Hand Size and Endoscopic Training,” Dig. Dis. Sci., 53(7), pp. 1902–1909. [CrossRef] [PubMed]
Adams, D. M. , Fenton, S. J. , Schirmer, B. D. , Mahvi, D. M. , Horvath, K. , and Nichol, P. , 2008, “ One Size Does Not Fit All: Current Disposable Laparoscopic Devices Do Not Fit the Needs of Female Laparoscopic Surgeons,” Surg. Endosc., 22(10), pp. 2310–2313. [CrossRef] [PubMed]
Harvin, G. , 2014, “ Review of Musculoskeletal Injuries and Prevention in the Endoscopy Practitioner,” J. Clin. Gastroenterol., 48(7), pp. 590–594. [CrossRef] [PubMed]
Kono, E. , Tada, M. , Kouchi, M. , Endo, Y. , Tomizawa, Y. , Matsuo, T. , and Nomura, S. , 2014, “ Ergonomic Evaluation of a Mechanical Anastomotic Stapler Used by Japanese Surgeons,” Surg. Today, 44(6), pp. 1040–1047. [CrossRef] [PubMed]
Kono, E. , Tomizawa, Y. , Matsuo, T. , and Nomura, S. , 2012, “ Rating and Issues of Mechanical Anastomotic Staplers in Surgical Practice: A Survey of 241 Japanese Gastroenterological Surgeons,” Surg. Today, 42(10), pp. 962–972. [CrossRef] [PubMed]
Park, A. , Lee, G. , Seagull, F. J. , Meenaghan, N. , and Dexter, D. , 2010, “ Patients Benefit While Surgeons Suffer: An Impending Epidemic,” J. Am. Coll. Surg., 210(3), pp. 306–313. [CrossRef] [PubMed]
Greiner, T. M. , 1991, Hand Anthropometry of U.S. Army Personnel, U.S. Army Natick Research, Development & Engineering Center, Natick, MA.
Filisetti, C. , Cho, A. , Riccipetitoni, G. , and Saxena, A. K. , 2015, “ Analysis of Hand Size and Ergonomics of Instruments in Pediatric Minimally Invasive Surgery,” Surg. Laparosc. Endosc. Percutan. Tech., 25(5), pp. e159–e162. [CrossRef] [PubMed]
Pheasant, S. , and Haslegrave, C. M. , 2005, Bodyspace: Anthropometry, Ergonomics and the Design of Work, 3rd ed., CRC Press, Boca Raton, FL.
Welcker, K. , Kesieme, E. B. , Internullo, E. , and Kranenburg van Koppen, L. J. C. , 2012, “ Ergonomics in Thoracoscopic Surgery: Results of a Survey Among Thoracic Surgeons,” Interact. Cardiovasc. Thorac. Surg., 15(2), pp. 197–200. [CrossRef] [PubMed]
Uhrich, M. L. , Underwood, R. A. , Standeven, J. W. , Soper, N. J. , and Engsberg, J. R. , 2002, “ Assessment of Fatigue, Monitor Placement, and Surgical Experience During Simulated Laparoscopic Surgery,” Surg. Endosc., 16(4), pp. 635–639. [CrossRef] [PubMed]
Meara, J. G. , Leather, A. J. M. , Hagander, L. , Alkire, B. C. , Alonso, N. , Ameh, E. A. , Bickler, S. W. , Conteh, L. , Dare, A. J. , Davies, J. , Mérisier, E. D. , El-Halabi, S. , Farmer, P. E. , Gawande, A. , Gillies, R. , Greenberg, S. L. M. , Grimes, C. E. , Gruen, R. L. , Ismail, E. A. , Kamara, T. B. , Lavy, C. , Lundeg, G. , Mkandawire, N. C. , Raykar, N. P. , Riesel, J. N. , Rodas, E. , Rose, J. , Roy, N. , Shrime, M. G. , Sullivan, R. , Verguet, S. , Watters, D. , Weiser, T. G. , Wilson, I. H. , Yamey, G. , and Yip, W. , 2016, “ Global Surgery 2030: Evidence and Solutions for Achieving Health, Welfare, and Economic Development,” Int. J. Obstet. Anesth., 25, pp. 75–78. [CrossRef] [PubMed]
Fuchs, K. H. , Babic, B. , Breithaupt, W. , Dallemagne, B. , Fingerhut, A. , Furnee, E. , Granderath, F. , Horvath, P. , Kardos, P. , Pointner, R. , Savarino, E. , Van Herwaarden-Lindeboom, M. , and Zaninotto, G. , and European Association of Endoscopic Surgery (EAES), 2014, “ EAES Recommendations for the Management of Gastroesophageal Reflux Disease,” Surg. Endosc., 28(6), pp. 1753–1773. [CrossRef] [PubMed]
Myers, S. R. , McGuirl, J. , and Wang, J. , 2013, “ Robot-Assisted Versus Laparoscopic Gastric Bypass: Comparison of Short-Term Outcomes,” Obes. Surg., 23(4), pp. 467–473. [CrossRef] [PubMed]
Anakwe, R. E. , Huntley, J. S. , and McEachan, J. E. , 2007, “ Grip Strength and Forearm Circumference in a Healthy Population,” J. Hand Surg. Eur. Vol., 32(2), pp. 203–209. [CrossRef] [PubMed]
Edgren, C. S. , Radwin, R. G. , and Irwin, C. B. , 2004, “ Grip Force Vectors for Varying Handle Diameters and Hand Sizes,” Hum. Factors, 46(2), pp. 244–251. [CrossRef] [PubMed]


Grahic Jump Location
Fig. 3

Histogram of preferred glove size versus gender. Over 48 male and 8 female general surgeons had their preferred glove size recorded. The sizes were normally distributed among men and women. The numbers over the bar indicate amount of men and women at that particular size (P < 0.001).

Grahic Jump Location
Fig. 2

Common laparoscopic surgical stapler measurements. The top arrow on the schematic stapler diagram represents the proximal trigger distance and the bottom arrow represents the distal trigger distance while the devices were in “fire-mode”.

Grahic Jump Location
Fig. 1

Hand anthropometry measurements summary. Digit 1 Length is taken from the distal tip of the thumb to the palmar digit 1 crease. Digit 2 link length is the distance from the distal tip of the index finger to the MCP Joint, measured using the proximal transverse palmar crease. Digit 2 distance from D2 MCP joint to DIP joint is the distance from the D2 DIP Joint to the proximal transverse palmar crease. Maximum grip diameter is taken by having the subject touch the distal tips of the first and third digits together and slide them over a cone until the two digits can no longer touch. Hand Circumference is taken around the widest part of the palm, typically around the breadth of the knuckles.

Grahic Jump Location
Fig. 4

Normal distribution of male and female surgeon D2 MCP to DIP joint measurement compared with laparoscopic stapler proximal trigger distance. The curves are the normal distribution of male and female surgeon's distance from D2 MCP to DIP Joint. The Stapler 1 reference line (leftmost vertical dashed line) is the proximal grip distance on the stapler 1 (5.13 cm). The Stapler 2 reference line (rightmost vertical dashed line) is the proximal grip distance on the stapler 2 (6.83 cm). These locations are typically where the index finger would be located during firing of the surgical stapler.



Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related Journal Articles
Related eBook Content
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In