Ergonomic mismatch in circular staplers: powered staplers are associated with reduced sex-related disparities.

BACKGROUND: Manual circular staplers have been recognized as difficult to operate, particularly for female surgeons. Recently, powered circular staplers have been developed to address these limitations. This study aimed to describe surgeons' satisfaction and perceived challenges with manual and powered staplers and evaluate sex-related differences in operability. METHODS: A web-based survey was conducted among 18,261 members of the Japanese Society of Gastroenterological Surgery. The questionnaire collected demographic data, including sex, years since medical registration, and surgical glove size. It also assessed perceptions of manual and powered circular staplers, including stress or anxiety during use, situations associated with operational difficulty, overall satisfaction, and desired improvements. RESULTS: A total of 1,007 responses were obtained (859 men, 144 women, and four other/no response), yielding a response rate of 5.5%. Female surgeons had smaller glove sizes and fewer years of experience than male surgeons. With manual staplers, female surgeons reported higher levels of stress and anxiety during firing and lower overall satisfaction. The main issues identified were firing, handle size, and device weight. In contrast, powered staplers mitigated many of these challenges, improved satisfaction in both groups, and reduced sex-related differences in stressful situations during stapler operation. CONCLUSIONS: Powered circular staplers were associated with higher satisfaction than manual staplers among both male and female surgeons and may help reduce sex-related differences in operability. However, statistically significant sex-related differences persisted for some outcomes, and issues related to device weight remain, highlighting the need for further ergonomic improvements.