Nagaraj Madhuri B, AbdelFattah Kareem R, Farr Deborah E
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
J Surg Res. 2022 Jul;275:203-207. doi: 10.1016/j.jss.2022.02.003. Epub 2022 Mar 17.
There is a paucity of objective data about the advantages or disadvantages of handedness in surgery. Given the need for ambidexterity in laparoscopic surgery, our study aimed to identify the patterns in handedness and performance on basic laparoscopic tasks.
A retrospective analysis of intern laparoscopic performance on bimanual tasks was assessed for delta time (differences in task time between the dominant and nondominant hand) between left-hand and right-hand dominant interns.
Data were analyzed for 16 residents. 25% were left-handed dominant (4/16) and 75% were right-handed dominant (12/16). Of the left-handed surgeons, 75% (3/4) operated primarily with their right hand. There was a significant difference between the time to task completion in Task 2 of left-handed and right-handed residents with median (IQR) time 94 s (90.25-97) and 127 s (104.25-128.5), respectively (P value = 0.02). No significant difference was seen between left-handed and right-handed residents on Task 1 (50 s versus 49 s) and Task 3 (51 s versus 59.5 s). In all three tasks, however, left-handed dominant residents had smaller variability (IQR 4.5-8 s versus 7-24.25 s) and significantly shorter delta times.
Although true ambidexterity is rare, the ability to be facile with both hands is crucial for laparoscopic surgery. Our data show that variability in performance between the dominant hand and nondominant hand was remarkably smaller for left-hand dominant residents. This remains true despite the majority learning to operate with their nondominant hand. These data demonstrate a possible advantage to being left-hand dominant and may lead to further insights into variations of skill acquisition and improved curriculum development.
关于手术中使用利手的优缺点，客观数据较少。鉴于腹腔镜手术需要双手灵活操作，我们的研究旨在确定利手模式以及在基本腹腔镜任务中的表现。
对实习医生在双手任务中的腹腔镜操作表现进行回顾性分析，评估左利手和右利手实习医生之间的时间差（优势手和非优势手任务时间的差异）。
对16名住院医生的数据进行了分析。25%为左利手（4/16），75%为右利手（12/16）。在左利手外科医生中，75%（3/4）主要用右手操作。左利手和右利手住院医生在任务2中完成任务的时间存在显著差异，中位数（IQR）时间分别为94秒（90.25 - 97）和127秒（104.25 - 128.5）（P值 = 0.02）。在任务1（50秒对49秒）和任务3（51秒对59.5秒）中，左利手和右利手住院医生之间未观察到显著差异。然而，在所有三项任务中，左利手住院医生的变异性较小（IQR为4.5 - 8秒对7 - 24.25秒），且时间差显著更短。
虽然真正的双手灵活操作很少见，但双手熟练操作的能力对腹腔镜手术至关重要。我们的数据表明，左利手住院医生优势手和非优势手之间表现的变异性明显更小。尽管大多数人学习用非优势手操作，但情况仍然如此。这些数据表明左利手可能具有优势，并可能有助于进一步深入了解技能习得的差异和改进课程开发。
