title: Hand movements in laparoscopic suturing: a simple vector analysis.
abstract: BACKGROUND
  Laparoscopic suturing is a complex task that is vital to the performance of many advanced laparoscopic procedures. Mastery can be difficult and problematic for surgical trainees.
  
  
  METHODS
  We present a description of hand movements in laparoscopic suturing. Complex maneuvers are simplified into linear motions using vectors. The analysis is intended to be a tool for training in the art of laparoscopic surgery.
  
  
  RESULTS
  Linear hand movements in the x and y axes produce opposite motions at the instrument tip. Position along the z axis influences the extent of hand movement relative to the instrument tip. Rotational movements of the hand produce an equal rotation of the instrument tip. Revolution is a complex motion that combines movements in x and y axes. Vector analysis reveals that the arc of revolution must be reversed to produce the desired needle motion.
  
  
  CONCLUSIONS
  A conceptual understanding of hand-movement vectors facilitates the efficient mastery of the complex skills required for laparoscopic suturing.
authors.affiliation: Department of General Surgery, Mayo Clinic Scottsdale, 13400 E. Shea Boulevard, Scottsdale, AZ 85259, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Hansen
authors.forename: R T
authors.initials: RT
authors.lastname: Schlinkert
mesh_terms: D006804:Ergonomics; D006225:Hand / Q000502:physiology*; D006801:Humans; D010535:Laparoscopy; D008433:Mathematics; D009068:Movement; D013536:Suture Techniques