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不同利手和性别的先天性灵巧性及双手灵巧性程度:对腹腔镜手术训练的启示

Extent of innate dexterity and ambidexterity across handedness and gender: Implications for training in laparoscopic surgery.

作者信息

Elneel F H F, Carter F, Tang B, Cuschieri A

机构信息

Cuschieri Skills Centre, University of Dundee, Scotland, Italy.

出版信息

Surg Endosc. 2008 Jan;22(1):31-7. doi: 10.1007/s00464-007-9533-0. Epub 2007 Oct 27.

Abstract

BACKGROUND

As innate dexterity is considered one of the important predictors of eventual operative competence, an experimental human factors study was conducted to determine innate dexterity and ambidexterity across handedness and gender.

METHODS

50 medical students (right-handed males, left-handed males, and right-handed females) were recruited as participants in a study designed to assess innate dexterity and degree of ambidexterity for endoscopic manipulations in a validated virtual-reality simulator. All participants performed unilateral and bilateral tasks with both dominant and nondominant hands in random sequence. The outcome measures were execution time, extent of ambidexterity (ambidexterity index), aiming errors, and maximum tissue damage.

RESULTS

Right-handed males exhibited a greater level of ambidexterity than left-handed males (p = 0.02 for path length, p = 0.001 for angular path) and right-handed females (p = 0.01 for path length, p = 0.02 for angular path), and more-efficient task performance as measured by execution time (p = 0.001 for males and p = 0.03 across gender). The task quality when executed by the dominant hand was best in right-handed males (p = 0.001 vs. left-dominant males and p = 0.03 across gender). No significant difference was observed in terms of precision control and fine movements (aiming errors and maximum tissue damage) between the three groups.

CONCLUSIONS

These findings indicate that training surgical curricula in laparoscopic surgery should be more flexible to accommodate the innate differences across handedness and gender.

摘要

背景

由于先天灵活性被认为是最终手术能力的重要预测指标之一,因此开展了一项人体因素实验研究,以确定不同用手习惯和性别的先天灵活性及双手灵巧性。

方法

招募了50名医科学生(右利手男性、左利手男性和右利手女性)参与一项研究,该研究旨在通过经过验证的虚拟现实模拟器评估内镜操作的先天灵活性和双手灵巧程度。所有参与者以随机顺序用优势手和非优势手执行单侧和双侧任务。结果指标包括执行时间、双手灵巧程度(双手灵巧指数)、瞄准误差和最大组织损伤。

结果

右利手男性比左利手男性(路径长度p = 0.02,角路径p = 0.001)和右利手女性(路径长度p = 0.01,角路径p = 0.02)表现出更高的双手灵巧性,并且从执行时间衡量的任务表现更高效(男性p = 0.001,跨性别p = 0.03)。优势手执行任务时的质量在右利手男性中最佳(与左优势手男性相比p = 0.001,跨性别p = 0.03)。三组之间在精确控制和精细动作(瞄准误差和最大组织损伤)方面未观察到显著差异。

结论

这些发现表明,腹腔镜手术的外科培训课程应更灵活,以适应不同用手习惯和性别的先天差异。

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