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      The Left-handed Plastic Surgery Trainee: Perspectives and Recommendations

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          Background:

          Left-handed surgeons experience difficulty with tools designed for use in the right hand. The purpose of this study was to examine instrument laterality and to survey the experiences of left-handed plastic surgery trainees.

          Methods:

          Count sheets for plastic surgery trays (reconstructive, microsurgery, rhinoplasty, craniofacial) were acquired from Tisch Hospital, NYU Langone Health. Instruments with right-handed laterality were tallied. A survey was also distributed to plastic surgery residents and fellows to determine hand preference for surgical tasks, and those who identified as left-handed described how handedness impacted their training.

          Results:

          Right-handed laterality was seen in 15 (31.3%) of the 48 reconstructive instruments, 17 (22.7%) of the 75 rhinoplasty instruments, and 22 (31.0%) of the 71 craniofacial instruments. One-hundred percent of the 25 microsurgery instruments were ambidextrous. There were 97 survey responses. Trainees (17.5%) were identified as left-handed and were more likely than right-handed trainees to report operating with both hands equally or with the opposite hand (47.1% versus 1.3%; P < 0.001). Left-handed trainees were significantly more likely than right-handed trainees to use their nondominant hand with scissors ( P < 0.001), electrocautery ( P = 0.03), and needle drivers ( P < 0.001) and when performing tissue dissection ( P < 0.001) and microsurgery ( P = 0.008). There was no difference in use of the nondominant hand between right and left-handed trainees for knot tying ( P = 0.83) and in use of the scalpel ( P = 0.41).

          Conclusions:

          Left-handed plastic surgery trainees frequently encounter instruments designed for the nondominant hand, with which they adaptively perform several surgical tasks. Mentoring may help trainees overcome the laterality-related challenges of residency.

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          Most cited references23

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          Work-Related Musculoskeletal Injuries in Plastic Surgeons in the United States, Canada, and Norway

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            The da Vinci(®) Surgical System overcomes innate hand dominance.

            The robotic surgical platform has allowed for improved ergonomics, tremor filtration, and more precise surgical movements during minimally invasive surgery. We examined the impact of the da Vinci(®) Surgical System on the lateralization of manual dexterity, or handedness, innate to most surgeons. Manual dexterity assessments were conducted among 19 robotic novices using two different skills tests: The Purdue Pegboard Test and a needle targeting test. After an initial robotic basic skills training seminar, subjects underwent testing using both open and robotic approaches. Test performance using both approaches was then compared among all subjects. The majority of subjects (84%) were right handed, and all subjects described their dominant hand as significantly or moderately more dexterous than their nondominant hand. The participants had significant differences between the dominant and nondominant hand in open skills tasks using the Purdue Pegboard test (15.4 vs 14.6 pegs, P=0.023) and needle targeting test (4.5 vs 3.7 targets, P=0.015). When the same tasks were performed using the robot, the differences in handedness were no longer observed (P=0.203, P=0.764). The da Vinci robot is capable of eliminating innate dexterity or handedness among novice surgical trainees. This provides evidence of another beneficial aspect of robot-assisted surgery over traditional laparoscopic surgery and may facilitate operative performance of complex tasks.
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              Left-handed surgeons: are they left out?

              Left-handedness has been considered a simple inconvenience by some or something as convoluted as "the sinister," the Latin word for the left, by others. One in ten medical personnel is left-handed. The perceptions of left-handed surgeons regarding their laterality related inconveniences are unknown.
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                Author and article information

                Journal
                Plast Reconstr Surg Glob Open
                Plast Reconstr Surg Glob Open
                GOX
                Plastic and Reconstructive Surgery Global Open
                Wolters Kluwer Health
                2169-7574
                May 2020
                21 May 2020
                : 8
                : 5
                : e2686
                Affiliations
                From the [* ]Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, N.Y.
                []Dallas Plastic Surgery Institute, Dallas, Tex.
                Author notes
                Pierre B. Saadeh, MD, Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, 305 E 33rd St, New York, NY 10016, E-mail: pierre.saadeh@ 123456nyumc.org
                Article
                00032
                10.1097/GOX.0000000000002686
                7572112
                6b8e7b07-be46-4de3-b1e7-036cc987ac62
                Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : 22 November 2019
                : 15 January 2020
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