Anesthesia and OR Equipment for Left-Handed Clinicians
Approximately 10–11% of clinicians are left-handed, yet medical environments are often designed for the right-handed majority.1-3 This default right-handedness extends from basic surgical instruments to the layout of operating rooms (ORs) and anesthesia workstations.2 In the past, left-handedness was viewed as a liability, and left-handed clinicians had limited access to appropriate equipment.1,3 Although overt discrimination is now uncommon, left-handed clinicians continue to face ergonomic challenges in the OR due to equipment design.2
The most immediate challenge lies in the mechanical design of standard surgical instruments. Scissors and needle drivers are engineered for right-handed use, such that a natural squeezing motion forces the blades together to create a clean cut.3,4 Box-lock mechanisms on hemostats and needle drivers are similarly optimized for right-handed thumb pressure, allowing easy release. For left-handed users, this orientation frequently requires an awkward pulling motion toward the palm, increasing fatigue and reducing precision.3,4
Despite widespread recognition of these issues, access to left-handed instruments in the OR remains limited. Only 13% of surgical residency programs report routinely providing left-handed tools, leaving many left-handed trainees to adapt to using their non-dominant hand.1
Beyond instruments, OR layout itself is typically configured for right-handed workflow. Monitor placement, anesthesia machines, and IV poles are commonly fixed in positions that favor right-handed operators. As a result, left-handed clinicians often modify procedural approaches. In a web-based survey of 68 left-handed surgeons, 78% reported preferring the left forearm for peripheral venous cannulation, and 59% preferred the left radial artery for arterial line placement.1
Few respondents in the same study reported routinely altering room or monitor setup for endoscopic procedures; most instead adapted to the existing configuration. These adaptations vary. For example, some clinicians use their right foot to activate electrocautery pedals, while others adjust their stance to use the left foot, a maneuver that can be awkward in confined OR spaces.1,3
These mismatches are not merely inconvenient. Left-handed clinicians report higher rates of needlestick injuries compared with right-handed colleagues, underscoring the safety implications of equipment and protocol bias. Practical mitigation strategies include documenting handedness for surgeons and anesthesiologists and ensuring OR staff proactively adjust instrument passing and room setup.1,3
In response to these constraints, many left-handed clinicians develop what has been termed “situational ambidexterity,” achieving greater proficiency with their non-dominant hand than typically seen in right-handed peers.2 While this adaptation can be advantageous, it is largely self-taught. Left-handed trainees rarely receive formal mentoring related to laterality during medical school or residency.1 Ultimately, this forced adaptability reflects a systemic failure to provide appropriate tools and training, imposing extra physical and cognitive burdens on left-handed clinicians and limiting their ability to perform at full efficiency.2
References
1. Adusumilli PS, Kell C, Chang JH, Tuorto S, Leitman IM. Left-handed surgeons: are they left out? Curr Surg. 2004;61(6):587-591. doi:10.1016/j.cursur.2004.05.022
2. Brooks NE, Lipman JM, French JC. The right way to teach lefties: exploring the experiences of left-handed trainees and surgeons. J Surg Educ. 2023;80(11):1552-1566. doi:10.1016/j.jsurg.2023.05.004
3. Denison ME, Awad K, Gillen JR, Nussbaum MS, Collier BR. Issues and strategies in training left-handed surgeons. Am Surg. 2023;89(12):5107-5111. doi:10.1177/00031348231175119
4. Bishop RC. Left-handed use of surgical instruments: improved function through understanding instrument design. JAVMA. Published online January 8, 2025. doi:10.2460/javma.24.11.0717