The da Vinci Robot System Eliminates Multispecialty Surgical Trainees' Hand Dominance in Open and Robotic Surgical Settings

Abstract

Background and Objectives:Handedness, or the inherent dominance of one hand's dexterity over the other's, is a factor in open surgery but has an unknown importance in robot-assisted surgery. We sought to examine whether the robotic surgery platform could eliminate the effect of inherent hand preference.Methods:Residents from the Urology and Obstetrics/Gynecology departments were enrolled. Ambidextrous and left-handed subjects were excluded. After completing a questionnaire, subjects performed three tasks modified from the Fundamentals of Laparoscopic Surgery curriculum. Tasks were performed by hand and then with the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, California). Participants were randomized to begin with using either the left or the right hand, and then switch. Left:right ratios were calculated from scores based on time to task completion. Linear regression analysis was used to determine the significance of the impact of surgical technique on hand dominance.Results:Ten subjects were enrolled. The mean difference in raw score performance between the right and left hands was 12.5 seconds for open tasks and 8 seconds for robotic tasks (P < .05). Overall left-right ratios were found to be 1.45 versus 1.12 for the open and robot tasks, respectively (P < .05). Handedness significantly differed between robotic and open approaches for raw time scores (P < .0001) and left-right ratio (P = .03) when controlling for the prior tasks completed, starting hand, prior robotic experience, and comfort level. These findings remain to be validated in larger cohorts.Conclusion:The robotic technique reduces hand dominance in surgical trainees across all task domains. This finding contributes to the known advantages of robotic surgery.

Impact of surgeon handedness in manual and robot-assisted total hip arthroplasty

“…Handedness is also called the lateralization of chirality, which is defined as the property of using one hand more than the other [21]. The effect of handedness, which can be reflected in most of surgery, is not generally considered to have a significant effect on their surgical outcome, because surgeons can adjust their positioning and perspective to optimize intracorporeal maneuverability [21]. However, the impact of handedness on orthopedic surgery is far greater than other surgeries.…”

Impact of Surgeon Handedness in Manual and Robot-assisted Total Hip Arthroplasty

“…Handedness is also called the lateralization of chirality, which is defined as the property of using one hand more than the other [21]. The effect of handedness, which can be reflected in most of surgery, isn't generally considered to have a significant effect on their surgical outcome, because surgeons can adjust their positioning and perspective to optimize intracorporeal maneuverability [21].…”

“…In the recent years, sophisticated tools have been emerging to reduce the differences between surgeons and sides. In addition to these tools, robot might be one alternative to eliminate the adverse influence of handedness [4,21,27]. However, as the surgeon has to use the non-dominant hand to complete critical procedures, such as acetabular registration, reaming and cup implantation during robot-assisted THA of the non-dominant side, the surgeon's handedness could still influence the cup positioning theoretically.…”

Impact of Surgeon Handedness in Manual and Robot-assisted Total Hip Arthroplasty

“…Handedness is also called the lateralization of chirality, which is defined as the property of using one hand more than the other [21]. The effect of handedness, which can be reflected in most of surgery, isn't generally considered to have a significant effect on their surgical outcome, because surgeons can adjust their positioning and perspective to optimize intracorporeal maneuverability [21]. However, the impact of handedness on orthopedic surgery is far greater than other surgeries.…”

“…In the recent years, sophisticated tools have been emerging to reduce the differences between surgeons and sides. In addition to these tools, robot might be a perfect alternative to eliminate the adverse influence of handedness [4,21,23].…”