title: Manual Ambidexterity Predicts Robotic Surgical Proficiency.
abstract: BACKGROUND
  The manual dexterity of a surgeon is known to be related with surgical proficiency. Recently, as an objective measurement of surgical skills, inanimate methods using several types of simulators have been introduced. Using these simulators, we aimed to investigate the impact of manual dexterity on laparoscopic and robotic surgical proficiency.
  
  
  METHODS
  Fellow surgeons, surgical residents, and medical students (n = 32) participated in this study. For the measurement of dexterity, the sums and differences of the right and left hand performance times for the Grooved Pegboard Test were used as an index of dexterity speed and ambidexterity, respectively. The performance times during three sessions of laparoscopic suturing using a D-box trainer and the performance scores during three sessions using two robotic suturing programs with different degrees of difficulty provided by the da Vinci® Skills Simulator™ (Intuitive Surgical Inc., Sunnyvale, CA) were analyzed according to the measured manual dexterity.
  
  
  RESULTS
  Manual dexterity was not a significant factor for performance time during laparoscopic suturing, which was more influenced by participants' surgical experiences. In robotic suturing, the performance score was impacted significantly by manual dexterity in terms of ambidexterity rather than dexterity speed. For an easy robotic suturing task, the gap of proficiency between the lower and higher ambidexterity groups was decreased successively with each of the three sessions. However, that gap in cases with a difficult task was maintained consistently throughout all three sessions.
  
  
  CONCLUSIONS
  The degree of ambidexterity was an initial predictor for proficiency with simulated robotic suture. However, this relation could be lessened through a few sessions of training, although for a more difficult task further repetitions would be needed.
authors.affiliation: 1 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Jun-Young
authors.initials: JY
authors.lastname: Yang
authors.affiliation: 1 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Young-Gil
authors.initials: YG
authors.lastname: Son
authors.affiliation: 1 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Tae Han
authors.initials: TH
authors.lastname: Kim
authors.affiliation: 1 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Ji-Ho
authors.initials: JH
authors.lastname: Park
authors.affiliation: 1 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Yeon-Ju
authors.initials: YJ
authors.lastname: Huh
authors.affiliation: 1 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Yun-Suhk
authors.initials: YS
authors.lastname: Suh
authors.affiliation: 1 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Kong
authors.affiliation: 1 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea.|2 Cancer Research Institute, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Hyuk-Joon
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: 3 Department of Biomedical Engineering, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Sungwan
authors.initials: S
authors.lastname: Kim
authors.affiliation: 1 Department of Surgery, Seoul National University College of Medicine , Seoul, Korea.|2 Cancer Research Institute, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Han-Kwang
authors.initials: HK
authors.lastname: Yang
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D007839:Functional Laterality; D006801:Humans; D010535:Laparoscopy; D008297:Male; D065287:Robotic Surgical Procedures; D000066908:Simulation Training; D013536:Suture Techniques