Background And Purpose: The robotic surgical platform has allowed for improved ergonomics, tremor filtration, and more precise surgical movements during minimally invasive surgery. We examined the impact of the da Vinci(®) Surgical System on the lateralization of manual dexterity, or handedness, innate to most surgeons.
Methods: Manual dexterity assessments were conducted among 19 robotic novices using two different skills tests: The Purdue Pegboard Test and a needle targeting test. After an initial robotic basic skills training seminar, subjects underwent testing using both open and robotic approaches. Test performance using both approaches was then compared among all subjects.
Results: The majority of subjects (84%) were right handed, and all subjects described their dominant hand as significantly or moderately more dexterous than their nondominant hand. The participants had significant differences between the dominant and nondominant hand in open skills tasks using the Purdue Pegboard test (15.4 vs 14.6 pegs, P=0.023) and needle targeting test (4.5 vs 3.7 targets, P=0.015). When the same tasks were performed using the robot, the differences in handedness were no longer observed (P=0.203, P=0.764).
Conclusion: The da Vinci robot is capable of eliminating innate dexterity or handedness among novice surgical trainees. This provides evidence of another beneficial aspect of robot-assisted surgery over traditional laparoscopic surgery and may facilitate operative performance of complex tasks.
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http://dx.doi.org/10.1089/end.2011.0093 | DOI Listing |
JAMA Dermatol
January 2025
Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill.
Importance: Surgery is frequently required for hidradenitis suppurativa (HS) treatment, but the impact of common comorbidities such as obesity, diabetes, and smoking on outcomes has been sparsely studied.
Observations: A total of 12 studies met final inclusion criteria for investigating complication rates associated with at least 1 comorbidity. Complication rates were associated with obesity in 3 of 10 studies.
JAMA Netw Open
January 2025
Department of Pediatrics, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Importance: Pediatric obesity and hypertension are highly correlated. To mitigate both conditions, provision of counseling on nutrition, lifestyle, and weight to children with high blood pressure (BP) measurements is recommended.
Objective: To examine racial and ethnic disparities in receipt of nutrition, lifestyle, and weight counseling among patients with high BP at pediatric primary care visits stratified by patients' weight status.
JAMA Dermatol
January 2025
Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands.
Background: Interest in noninvasive treatment of basal cell carcinoma (BCC) has been increasing. For superficial BCC, it has been demonstrated that imiquimod cream, 5%, has high long-term efficacy, but for nodular BCC (nBCC), long-term evidence is sparse.
Objectives: To evaluate whether superficial curettage (SC) followed by imiquimod cream, 5%, is noninferior to surgical excision (SE) in nBCC after 5 years of treatment.
Importance: Delirium is common after cardiac surgery and associated with adverse outcomes. Intraoperative benzodiazepines may increase postoperative delirium but restricting intraoperative benzodiazepines has not yet been evaluated in a randomized trial.
Objective: To determine whether an institutional policy of restricted intraoperative benzodiazepine administration reduced the incidence of postoperative delirium.
JAMA Surg
January 2025
Department of General and Minimally Invasive Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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