Global perspectives on surgical instrument fit: unveiling challenges faced by urologists.

INTRODUCTION: To address the limited exploration of surgical ergonomics and instrument fit in urology, we evaluated the relationship between surgeons' hand size, glove fit, gender, and their perceived ease of using various urologic instruments. METHODS: An anonymous web-based survey was designed and distributed to members of the Endourology Society, Society of Women in Urology, and urology residency programs in the United States. It included demographics, perceived hand size/strength, ease of instrument use, and discomfort. RESULTS: Among 277 respondents (55% female, mean age 43.0 ± 11.4), 26% reported glove fit issues-more common in females (32% vs. 16%, p < 0.001). Nearly half (49%) reported hand size impacted their ability to use instruments and 52.73% reported having to make intraoperative adjustments in order to use the instruments effectively. Female urologists found all surgical instruments harder to use compared to their male counterparts (p < 0.05). Overall, 40% of respondents reported using some form of intervention to address discomfort and/or injury related to surgical instrument use (47% of females vs. 34% of males; p < 0.05). Female urologists and urologists with smaller hands reported significantly more discomfort using the flexible ureteroscope, disposable flexible ureteroscope, nephroscope, stapler, Ligasure, laparoscopic right angle, Trilogy™ and ShockPulse™ (p < 0.05). CONCLUSIONS: Our findings suggest that currently available urologic instruments do not fit a large subset of urologists. Industry collaboration is needed to address ergonomic disparities.