Physiologic tremor and microsurgery

Abstract

Physiologic tremor hampers the ability of students to learn microsurgical technique. An understanding of normal tremor both as to origin and methods of control would be of help. Physiological tremor arises from both mechanical and neuromuscular sources and is made worse by a number of factors. The "size principle of motoneuron recruitment" is an important physiologic consideration, and the use of biofeedback techniques enables the student to confirm his understanding of the principle. Knowledge of the factors which aggravate physiological tremor allows the microsurgeon to control his own tremor both in the laboratory and in the operating room.

Characteristics of hand motion of eye surgeons

“…Human hand movement has certain inherent involuntary components, including physiological tremor [1], jerk [2], and low frequency drift [3]. Suppression of these components would improve existing microsurgical practice and possibly allow the development of new procedures.…”

Application of fingertip support technique in microsurgery

“…The most obstructive problem is the physiological tremor which expands up to 0.4-0.6 mm even in the case of, well skilled microsurgeons us well 3,4,5,6 (Figure 1). Figure 1.…”

Static and dynamic accuracy of vitreoretinal surgeons

“…Human hand movement contains various involuntary components, including physiological tremor [1], jerk [2], and drift [3]. These components have limited performance in microsurgery, and cause certain types of procedures to be generally infeasible, such as retinal vein cannulation and arteriovenous sheathotomy [4].…”

“…Several one-dimensional (1-D) studies of motion have been reported for microsurgeons [1,7] and medical students [8]. Some studies have examined only physiological tremor [1,8], the roughly sinusoidal component of involuntary motion.…”