Supporting left-handed trainees in sinus and skull base surgery: A call for inclusive ergonomics

Area of Science:

• Neurosurgery
• Surgical Education
• Human Factors Engineering

Background:

• Endoscopic endonasal surgery (EES) requires precise, often bilateral, instrument manipulation.
• Surgeon hand dominance is a known factor influencing motor control and ergonomics.
• Adapting surgical environments to individual needs is crucial for effective training and performance.

Purpose of the Study:

• To investigate the impact of surgeon hand dominance on ergonomic challenges in endoscopic endonasal surgery.
• To identify specific difficulties faced by left-handed trainees during EES.
• To evaluate the effectiveness of operating room (OR) adjustments in optimizing ergonomics for left-handed surgeons.

Main Methods:

• Qualitative analysis of trainee experiences and surgeon feedback.
• Observational study of surgical procedures with varying OR configurations.
• Ergonomic assessments of instrument handling and surgeon posture during simulated and actual EES procedures.

Main Results:

• Significant ergonomic challenges were identified for left-handed surgeons, particularly with instrument triangulation and depth perception.
• Left-handed trainees reported a steeper learning curve for specific EES techniques compared to right-handed peers.
• Implementing specific OR adjustments, such as instrument table positioning and scope holder angles, demonstrably improved ergonomic comfort and efficiency for left-handed trainees.

Conclusions:

• Surgeon hand dominance is a critical factor influencing ergonomic efficiency in endoscopic endonasal surgery.
• Targeted OR modifications can effectively mitigate ergonomic disadvantages for left-handed trainees.
• Optimizing the surgical environment for left-handed surgeons enhances their training and surgical performance without compromising patient safety or the experience of right-handed surgeons.