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Published in: Surgical Endoscopy 7/2007

01-07-2007

Ringed silicon rubber attachment prevents laparoscopic surgeon’s thumb

Authors: N. Inaki, E. Kanehira, T. Kinoshita, K. Komai, K. Omura, G Watanabe

Published in: Surgical Endoscopy | Issue 7/2007

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Abstract

Background

This investigation, using the nerve conduction study, aimed to quantify the degree of laparoscopic surgeon’s thumb, and to evaluate the effect of the ringed silicon rubber attachment (RSRA) developed by the authors.

Methods

For the study, 26 residents or students performed surgical tasks (grasping and dissecting) using both the laparoscopic forceps with RSRA and the conventional instrument. The paresthesia was evaluated with a severity score obtained by interview and measurement of sensory nerve conduction velocity (SCV).

Results

The mean severity score was 2.57 ± 0.58 m/s for the conventional forceps and 1.05 ± 0.80 m/s for the forceps with RSRA (p < 0.01). For the grasping task with the conventional forceps, the mean SCV was 58.3 ± 2.81 m/s before and 54.8 ± 2.83 m/s after the task (p < 0.01), whereas for the dissecting task, the corresponding values were 57.5 ± 2.46 m/s and 56.1 ± 2.93 m/s (p < 0.01). For the grasping task with the RSRA, the mean SCV was 57.1 ± 3.33 m/s before and 55.9 ± 3.18 m/s after the task (p < 0.01), whereas for the dissecting task, the corresponding values were 55.7 ± 4.59 m/s and 55.8 ± 3.50 m/s (nonsignificant difference).

Conclusions

Laparoscopic surgeon’s thumb was induced by compression of the lateral digital nerve. The RSRA significantly reduced the degree of paresthesia.
Literature
1.
go back to reference Buschbacher RM (1999) Median 14-cm and 7-cm antidromic sensory studies to digits two and three. Am J Phys Med Rehabil 78: S53–S62PubMedCrossRef Buschbacher RM (1999) Median 14-cm and 7-cm antidromic sensory studies to digits two and three. Am J Phys Med Rehabil 78: S53–S62PubMedCrossRef
2.
go back to reference De Jesus PV, Hausmanowa-Petrusewicz I, Barchi RL (1973) The effect of cold on nerve conduction of human slow and fast nerve fibers. Neurology 23: 1182–1189PubMed De Jesus PV, Hausmanowa-Petrusewicz I, Barchi RL (1973) The effect of cold on nerve conduction of human slow and fast nerve fibers. Neurology 23: 1182–1189PubMed
3.
go back to reference Horgan LF, O’Riordan DC, Doctor N (1997) Neuropraxia following laparoscopic procedures: an occupational injury. Min Invas Ther Allied Technol 6: 33–35 Horgan LF, O’Riordan DC, Doctor N (1997) Neuropraxia following laparoscopic procedures: an occupational injury. Min Invas Ther Allied Technol 6: 33–35
4.
go back to reference Kano N, Yamakawa T, Ishikawa Y, Miyajima N, Ohtaki S, Kasugai H (1995) Prevention of laparoscopic surgeon’s thumb. Surg Endosc 9: 738–739PubMed Kano N, Yamakawa T, Ishikawa Y, Miyajima N, Ohtaki S, Kasugai H (1995) Prevention of laparoscopic surgeon’s thumb. Surg Endosc 9: 738–739PubMed
5.
go back to reference Kano N, Yamakawa T, Kasugai H (1993) Laparoscopic surgeon’s thumb. Arch Surg 128: 1172PubMed Kano N, Yamakawa T, Kasugai H (1993) Laparoscopic surgeon’s thumb. Arch Surg 128: 1172PubMed
6.
go back to reference Lewis T, Pickering GW, Rothschild P (1931) Centripetal paralysis arising out of arrested blood flow to the limb, including notes on a form of tingling. Heart 16: 1 Lewis T, Pickering GW, Rothschild P (1931) Centripetal paralysis arising out of arrested blood flow to the limb, including notes on a form of tingling. Heart 16: 1
7.
go back to reference Lowe JB III, Sen SK, Mackinnon SE (2002) Current approach to radial nerve paralysis. Plast Reconstr Surg 110: 1099–1113PubMedCrossRef Lowe JB III, Sen SK, Mackinnon SE (2002) Current approach to radial nerve paralysis. Plast Reconstr Surg 110: 1099–1113PubMedCrossRef
8.
go back to reference Majeed AW, Jacob G, Reed MW, Johnson AG (1993) Laparoscopist’s thumb: an occupational hazard. Arch Surg 128: 357PubMed Majeed AW, Jacob G, Reed MW, Johnson AG (1993) Laparoscopist’s thumb: an occupational hazard. Arch Surg 128: 357PubMed
9.
go back to reference Nasr JT, Kaufman MA (2001) Electrophysiologic finding in two patients with digital neuropathy of the thumb. Erectromyogr Clin Neurophysiol 41: 353–356 Nasr JT, Kaufman MA (2001) Electrophysiologic finding in two patients with digital neuropathy of the thumb. Erectromyogr Clin Neurophysiol 41: 353–356
10.
go back to reference Neuhous SJ, Watoson DI (1997) Laparoscopic surgeons’ thumb: is it a training phenomenon? Min Invas Ther Allied Technol 6: 31–32CrossRef Neuhous SJ, Watoson DI (1997) Laparoscopic surgeons’ thumb: is it a training phenomenon? Min Invas Ther Allied Technol 6: 31–32CrossRef
12.
go back to reference Seddon H (1975) Surgical disorders of peripheral nerves. 2nd ed. Churchill Livingstorne, Edinburgh Seddon H (1975) Surgical disorders of peripheral nerves. 2nd ed. Churchill Livingstorne, Edinburgh
14.
go back to reference Woo JL, Yoon SC (2001) Superficial nerve damage of thumb of laparoscopic surgeon. Surg Laparosc Percutan Tech 11: 207–208CrossRef Woo JL, Yoon SC (2001) Superficial nerve damage of thumb of laparoscopic surgeon. Surg Laparosc Percutan Tech 11: 207–208CrossRef
15.
go back to reference Zee DC, Bax NMA (1995) Digital nerve compression due to laparoscopic surgery. Surg Endosc 9: 740PubMed Zee DC, Bax NMA (1995) Digital nerve compression due to laparoscopic surgery. Surg Endosc 9: 740PubMed
Metadata
Title
Ringed silicon rubber attachment prevents laparoscopic surgeon’s thumb
Authors
N. Inaki
E. Kanehira
T. Kinoshita
K. Komai
K. Omura
G Watanabe
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 7/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-006-9061-3

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