Abstract
Purpose :
Hand positioning and instrument grasp techniques are commonly discussed during surgical training. However, there is a dearth in the literature of formal assessments and characterizations of hand position during ophthalmic surgery. Additionally, it is not known whether hand size or level of training may affect hand positioning or instrument grasp styles. We sought to characterize ophthalmic surgical hand grasp positions using a novel three-dimensional image tracker, and also sought to assess whether differences in positioning or maneuver duration existed across different levels of training and hand sizes.
Methods :
Faculty and resident volunteers (N=7) performed seven surgical maneuvers while their grasp and hand motion was recorded using a 3-dimensional hand tracker and software package (Leap Motion Controller, UltraLeap, Mountain View CA). Recordings were reviewed to categorize instrument grasp style and duration of specific maneuvers. Grasp styles were categorized by the style they most closely resembled for holding writing implements (dynamic tripod, dynamic quadrupod, lateral tripod, lateral quadrupod, and other).
Results :
In this small study all faculty and resident ophthalmologists utilized a dynamic tripod grasp except one resident who used a dynamic quadrupod grasp with forceps only. Residents took longer to perform five of the seven surgical maneuvers, but there were no significant differences between groups. Hand size had no significant effect on maneuver duration.
Conclusions :
This is the first study to characterize hand positioning and instrument grasp techniques for ophthalmic surgery using three-dimensional image analysis. The most common type of instrument grasp among studied participants was the dynamic tripod grasp. Three-dimensional hand tracking is a developing tool that may aid in our understanding of grasp and surgical instrument manipulation and has great potential for enhancing surgical education strategies. Although no significant differences were noted across hand size or training level for this small pilot study, further study can be undertaken to study these nuances.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.