The da vinci robot system eliminates multispecialty surgical trainees' hand dominance in open and robotic surgical settings.
OBJECTIVE
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.


CONCLUSIONS
The robotic technique reduces hand dominance in surgical trainees across all task domains. This finding contributes to the known advantages of robotic surgery.
Department of Urology, Columbia University, College of Physicians and Surgeons, New York, New York, USA.
Gina M
GM
Badalato
Department of Urology, Columbia University, College of Physicians and Surgeons, New York, New York, USA.
Edan
E
Shapiro
Department of Urology, Columbia University, College of Physicians and Surgeons, New York, New York, USA.
Michael B
MB
Rothberg
Department of Urology, Columbia University, College of Physicians and Surgeons, New York, New York, USA.
Ari
A
Bergman
Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, New York, USA.
Arindam
A
RoyChoudhury
Department of Urology, Columbia University, College of Physicians and Surgeons, New York, New York, USA.
Ruslan
R
Korets
Department of Urology, Columbia University, College of Physicians and Surgeons, New York, New York, USA.
Trushar
T
Patel
Department of Urology, Columbia University, College of Physicians and Surgeons, New York, New York, USA.
Ketan K
KK
Badani
D000328:Adult; D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D005260:Female; D006225:Hand; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008297:Male; D011597:Psychomotor Performance; D012371:Robotics / Q000193:education* / Q000295:instrumentation; D055815:Young Adult
Hand dominance; Handedness; Robotics; Surgical education/training