Hand position in microsurgery

Nissenbaum, Mark; Meckler, Roy J.; Acland, Robert D.

doi:10.1016/s0363-5023(79)80127-6

Cited by 10 publications

(10 citation statements)

References 1 publication

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“…Subjects held the device with their dominant hand in a writer's grip, 4 cm from the needle tip. In order to achieve optimum stability, the dominant upper extremity was placed in the ''full rest position'' as described by Nissenbaum et al, 7 with full support extending from the elbow to the little finger. The nondominant arm was also placed on the table in a similar position, in order to maximize stability of the entire torso.…”

Section: Methodsmentioning

confidence: 99%

Effect of exercise on microsurgical hand tremor

Hsu

Cooley

2003

Microsurgery

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This study investigated the effects of upper-body and aerobic/lower-body-only (nonupper-body) exercise on microsurgical hand tremor. Subjects were given a task of holding a microsurgical needle tip over a small target, with video-microscopic documentation immediately before and 0, 2, 4, 8, and 24 h after either upper-body or nonupper-body (aerobic) exercise. Tremor was quantified by the amount of time the needle was maintained within a 100 x 100-microm target zone and the number of times the needle extruded from the zone. Both upper-body and aerobic-only exercise groups had significant increases in tremor immediately after exercise (P < 0.02), with a return to baseline tremor 2 h after exercise in the aerobic group and only a slightly prolonged return to baseline (by 4 h) in the majority of upper-body exercise subjects. These findings demonstrate that microsurgical hand tremor increases following exercise, but returns to baseline within 4 h in the majority of individuals, particularly after aerobic-only workouts.

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Section: Methodsmentioning

confidence: 99%

Effect of exercise on microsurgical hand tremor

Hsu

Cooley

2003

Microsurgery

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“…Mostly, a pinch grip concerns precision works. In conventional surgeries, surgeons have worked precisely using their own dexterity based on the pinch grip . On the downside, the tension of hand muscles and the surrounding tissues can be more solicited with a pinch grip than with a power grip, the latter being associated with forceful works.…”

Section: Introductionmentioning

confidence: 99%

“…In conventional surgeries, surgeons have worked precisely using their own dexterity based on the pinch grip. 9 On the downside, the tension of hand muscles and the surrounding tissues can be more solicited with a pinch grip than with a power grip, the latter being associated with forceful works. More particularly, in the power grip, there is a strong relation observed between the gripping object and the hand, which implies that all movements of the object have to be initiated by the arm.…”

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confidence: 99%

Manipulation of a master manipulator with a combined‐grip‐handle of pinch and power grips

Jeong

Tadano

2020

Robotics Computer Surgery

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Conventional robotic surgery employs pinch and power grips for manipulating a master manipulator. As such, the manipulating methods exhibit limitations that are strongly related to the advantages and disadvantages of the gripping type. The context of this paper is focused on the introduction of a combined grip to compensate for such restraints. In particular, this paper proposed the combined‐grip‐handle scheme on a master manipulator, which employs both the pinch and power grips. A pointing experiment applying the master‐slave scheme was conducted with the master manipulator under several manipulating conditions of the combined grip and the conventional gripping types. Results of using the combined grip demonstrated that the positioning operation performed with fewer failures and required shorter time and trajectory. Compared with the conventional gripping types, the proposed combined grip showed better performance on the positioning operation and provided a possibility to perform precise work at lower scale factors.

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“…Upper extremity support has been shown to reduce surgeon hand tremor ( Arnold et al, 1993 ; Coulson et al, 2010 ; Evans, 1978 ; Hara et al, 2015 ; Nissenbaum et al, 1979 ). The effects of wrist support location on tremor have also been previously studied.…”

Section: Introductionmentioning

confidence: 99%

In Situ Tremor in Vitreoretinal Surgery

Wolf

Kulkarni

et al. 2020

Hum Factors

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Objective Surgeon tremor was measured during vitreoretinal microscopic surgeries under different hand support conditions. Background While the ophthalmic surgeon’s forearm is supported using a standard symmetric wrist rest when operating on the patient’s same side as the dominant hand (SSD), the surgeon’s hand is placed directly on the patient’s forehead when operating on the contralateral side of the dominant hand (CSD). It was hypothesized that more tremor is associated with CSD surgeries than SSD surgeries and that, using an experimental asymmetric wrist rest where the contralateral wrist bar gradually rises and curves toward the patient’s operative eye, there is no difference in tremor associated with CSD and SSD surgeries. Methods Seventy-six microscope videos, recorded from three surgeons performing macular membrane peeling operations, were analyzed using marker-less motion tracking, and movement data (instrument path length and acceleration) were recorded. Tremor acceleration frequency and magnitude were measured using spectral analysis. Following 47 surgeries using a conventional symmetric wrist support, surgeons incorporated the experimental asymmetric wrist rest into their surgical routine. Results There was 0.11 mm/s2 (22%) greater ( p = .05) average tremor acceleration magnitude for CSD surgeries (0.62 mm/s2, SD = 0.08) than SSD surgeries (0.51 mm/s2, SD = 0.09) for the symmetric wrist rest, while no significant ( p > .05) differences were observed (0.57 mm, SD = 0.13 for SSD and 0.58 mm, SD = 0.11 for CSD surgeries) for the experimental asymmetric wrist rest. Conclusion The asymmetric wrist support reduced the difference in tremor acceleration between CSD and SSD surgeries.

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Hand position in microsurgery

Cited by 10 publications

References 1 publication

Effect of exercise on microsurgical hand tremor

Effect of exercise on microsurgical hand tremor

Manipulation of a master manipulator with a combined‐grip‐handle of pinch and power grips

In Situ Tremor in Vitreoretinal Surgery

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