“If you can’t handle this, you’ll never keep up with your peers.”
That’s what a young vascular surgeon in training reported hearing from a senior colleague during interviews for our study, after she needed two hands to hold a medical device her male peers could operate with one.
Another cardiologist, more than ten years into her career, must regularly hand over part of a procedure because she doesn’t have the grip strength for a particular surgical task. The problem isn’t her skill, focus, or stamina – it’s that the tools were never built for her hands.
Stories like these are sometimes misused to reinforce outdated stereotypes: that women aren’t physically capable of performing certain high-skill roles like heart surgery.
In reality, women surgeons are often working harder – and sometimes risking their own health – to achieve the same results as their male colleagues. The barrier isn’t ability. It’s the long shadow of gender bias in both medicine and design.
Our research team is working to change that. We’ve developed a test rig equipped with sensors and 3D scanning technology to capture precise measurements of grip strength and hand size across a variety of simulated surgical scenarios. So far, we’ve gathered data from 42 cardiologists and vascular surgeons worldwide.
The study involved 24 women vascular surgeons from across the globe, the response was overwhelmingly positive. Many participants shared personal accounts of the strain they endure, describing aching wrists and fear of long-term joint issues – all exacerbated by tools that demand more strength than their bodies can comfortably deliver. For some, the motivation to take part was personal: they want the next generation of surgeons to face fewer barriers.
This data is already being used to inform the design of new cardiovascular devices. Handles are being resized to fit a wider range of hand shapes, and the grip strength required to operate them is being lowered. The aim is simple but critical: reduce injury risk, improve surgeon wellbeing and extend careers.
Built for men, used by everyone
The operating theatre is full of devices designed to fit the “average” surgeon and, for decades, that average has been male. Handle diameters tend to be optimised for larger hands, while buttons and sliders are calibrated to force ranges comfortable for male grip strength.
In vascular and cardiac surgery, precision and power go hand in hand. These procedures require surgeons to maintain awkward positions for extended periods, often in high-pressure situations. Even without design flaws, the risk of muscle and joint strain is significant. But when a handle is too big to grip securely, or a control requires more force than a surgeon can comfortably exert, that risk increases sharply and disproportionately for women.
The impact isn’t only on the surgeon. Fatigue, strain and discomfort can affect concentration and precision, which in turn can influence patient outcomes. In a profession where the margin for error is vanishingly small, ergonomics aren’t a luxury — they’re a safety requirement.
When engineers develop new biomedical devices, they rely on design guidance: technical data on ideal handle sizes, optimal button placement and the comfortable grip force a surgeon should be able to apply.
But these guidelines are built on incomplete data. Historically, women were excluded from research studies, meaning their measurements never made it into the datasets that shape design.
Even when designers look for female-specific data, there either are no data or the sample sizes in studies are very small. One common shortcut is to scale down men’s measurements by 30-40% to “estimate” women’s — a crude approach that doesn’t reflect real-world variation in hand anatomy or grip strength.
The problem isn’t just gender. Ethnicity and age matter too. People of colour have long been underrepresented in health research, compounding the challenges faced by women of colour. The differences can be striking: the average grip strength of a European man is about 49kg, while for an Asian woman it’s around 24kg — yet both may be expected to perform identical surgical tasks with identical tools.
A changing profession needs changing tools
In 2025, women made up the majority of doctors in the UK for the first time — a milestone that signals a profession in transition. But the tools they will use are still rooted in outdated assumptions. The lack of inclusive design isn’t just an equity problem. It’s a practical one, affecting career longevity, workplace safety and ultimately patient care.
Calls to improve ergonomics for women in surgery have been growing louder. Professional organisations, research groups and individual surgeons have all pushed for better-fitting, more adaptable tools. Yet progress has been slow, partly because gathering detailed ergonomic data has traditionally been time-consuming and expensive.
New technologies are changing that. With 3D scanning, advanced sensors, and more sophisticated modelling, it’s now possible to collect accurate, relevant data far more efficiently. This opens the door to design that accounts for the diversity of the surgical workforce — not just in gender and ethnicity, but in body size, strength and working style.
By integrating grip strength and hand size data from a truly representative group of surgeons, designers can move away from the “one-size-fits-all” mindset that has dominated for decades. Lowering the physical demands of surgical tools won’t just help women – it will improve comfort for all surgeons, from smaller men to older practitioners whose grip strength changes over time.
Heart surgery techniques have advanced rapidly in recent years, driving remarkable innovation and design. However, while technological progress has surged ahead, the data guiding these designs remains outdated and exclusionary, oftentimes leaving women in surgery an afterthought.
As today’s operating rooms evolve in diversity, we’re advocating for surgical instrument design to evolve with it – ensuring inclusivity is built into every medical device.
