Peg Board Research Articles

The Artisential® Articulated Laparoscopic Forceps: A Dry Lab Study to Examine Dexterity and Learning Effects in Operators with Different Levels of Laparoscopic Experience

Purpose: The advent of robotic surgery has highlighted the advantages of articulation. This dry-lab study examined the dexterity and learning effect of a new articulated laparoscopic instrument: the ArtiSential® forceps (LIVSMED, Seongnam, Republic of Korea). Methods: A peg board task was designed. Three groups of volunteers with varying levels of laparoscopic expertise were organized to perform the task: expert, intermediate and novice. The participants performed the task using articulated and straight instruments, once before a 30-min training session and once afterwards. The times required to perform the task were recorded. The performances were analyzed and compared between the groups as well as between the straight and articulated instruments. Results: The experts were significantly faster than the novices with both instruments before the 30-min training session (p = 0.0317 for each instrument). No significant time difference was found among the three groups after the 30-min training session. The decrease in the time required to perform the peg-transfer task with the articulated instrument was significantly greater in the novice and intermediate groups (p = 0.0159 for each group). No significant difference in time reduction was observed between the groups with the straight instrument. Regardless of the user, the articulated device was associated with faster task performance than the straight device after 8 hours of training (p = 0.0039). Conclusion: The ArtiSential® articulated device can improve dexterity. A significantly greater learning effect was observed in the novice and intermediate groups in comparison with experts. A plateau in the learning curve was observed after a few hours of training.

White matter microstructure relates to motor outcomes in myotonic dystrophy type 1 independently of disease duration and genetic burden

Deficits in white matter (WM) integrity and motor symptoms are among the most robust and reproducible features of myotonic dystrophy type 1 (DM1). In the present study, we investigate whether WM integrity, obtained from diffusion-weighted MRI, corresponds to quantifiable motor outcomes (e.g., fine motor skills and grip strength) and patient-reported, subjective motor deficits. Critically, we explore these relationships in the context of other potentially causative variables, including: disease duration, elapsed time since motor symptom onset; and genetic burden, the number of excessive CTG repeats causing DM1. We found that fractional anisotropy (a measure of WM integrity) throughout the cerebrum was the strongest predictor of grip strength independently of disease duration and genetic burden, while radial diffusivity predicted fine motor skill (peg board performance). Axial diffusivity did not predict motor outcomes. Our results are consistent with the notion that systemic degradation of WM in DM1 mediates the relationship between DM1 progression and genetic burden with motor outcomes of the disease. Our results suggest that tracking changes in WM integrity over time may be a valuable biomarker for tracking therapeutic interventions, such as future gene therapies, for DM1.

Measurement of finger tapping performance using a smartphone application: a pilot study.

[Purpose] Describe the measurement, reliability and validity of finger tapping repetitions recorded using a commercially available smartphone application (app). [Participants and Methods] We tested a convenience sample of 12 young right-handed participants who completed unilateral index finger tapping and peg board completion tasks with each hand. [Results] Measurement of finger tapping performance was practicable and was shown to be acceptably reliable and able to distinguish between performance of the dominant versus nondominant hand. Finger tapping was not correlated with pegboard performance. [Conclusion] A small sample of young adults showed that measures of finger tapping were easily obtained using a smartphone app. The measures demonstrated acceptable reliability and known groups validity. They, however, may not reflect performance at other measures of voluntary movement functions.

Forced use therapy to improve hand function in spastic cerebral palsy children

Introduction: Prehension, the ability to grasp, hold and manipulate objects is an important hand function. Impairment in hand function makes it difficult to fulfill activities of daily living. Objectives: To assess the effect of forced use therapy (FUT) in improving hand function of hemiplegic cerebral palsy children. Outcome measures: Modified Ashworth scale, Fegl Meyer assessment upper extremity, 9-hole peg board, upper extremity functional index and caregiver functional use survey are the outcome measures. Method: Fifty two children with cerebral palsy were divided into 2 groups A and B, 26 subjects in each group. Group A was given conventional hand function exercise whilst group B was given forced hand use therapy. Both groups received the treatment for 45 minutes for the affected limb for 5 days a week. But the FUT group was administered with gloves to constraint the hand movement for 6 hours daily. They were administered with the protocol for 4 weeks and outcomes were measured pre- and post-treatment duration. Results: FUT showed significantly better improvement over the conventional group in outcome measures (p Conclusions: FUT caused reduction in spasticity and increased functional ability in children with spastic hemiplegic cerebral palsy. Sri Lanka Journal of Child Health, 2020; 49(4): 335-340

White Matter Injury Is Associated with Reduced Manual Dexterity and Elevated Serum Ceramides in Subjects with Cerebral Small Vessel Disease

Introduction: We have demonstrated that asymptomatic cerebral small vessel disease (cSVD) measured by white matter hyperintensity volume is associated with reduced manipulative manual dexterity on the Grooved Peg Board Test (GPBT) in middle-aged healthy individuals with a family history of early coronary artery disease. In this current study, we aim to identify the association of subcortical white matter microstructural impairment measured by diffusion tensor imaging, manual dexterity measured by GPBT and circulating serums ceramide, another marker for white matter injury. We hypothesize that lower regional fractional anisotropy (rFA) is associated with worse performance on GPBT and elevated serum ceramides in the same study population. Methods: rFA of 48 regions representing the subcortical white matters were analyzed in GeneSTAR participants in addition to serum ceramides and GPBT scores. Unadjusted univariable analyses with Bonferroni correction for multiple comparisons were completed using Spearman correlation for testing the associations between ceramides, rFA of subcortical white matter, and GPBT performance. Subsequently, sensitivity analyses were performed after excluding the participants that had any physical limitation that may influence their performance on GPBT. Finally, in the adjusted analysis using generalized estimating equation, linear regression models were performed for the areas that met significance threshold in the unadjusted analyses. Results: 112 subjects (age [49 ± 11], 51% female, 39.3% African American) were included. Adjusted analyses for the significant correlations that met the Bonferroni correction threshold in the unadjusted univariable analyses identified significant negative associations between rFA of the right fornix (RF) and log-GPBT score (β = −0.497, p = 0.037). In addition, rFA of RF negatively correlated with log serum ceramide levels (C18: β = −0.03, p = 0.003, C20: β = −0.0002, p = 0.004) and rFA of left genu of corpus callosum negatively correlated with log C18 level (β = −0.0103, p = 0.027). Conclusions: These results demonstrate that subcortical microstructural white matter disruption is associated with elevated serum ceramides and reduced manual dexterity in a population with cSVD. These findings suggest that injury to white matter tracts undermines neural networks, with functional consequences in a middle-aged population with cardiovascular risk factors.

Fundamentals of Laparoscopic Surgery Pro Tips Series Part 2: Tasks # 4 & 5

Study Objective This objective of this video is to describe several tips and tricks to help familiarize residents with the Fundamentals of Laparoscopic Surgery (FLS) tasks and to improve their technical skills and efficiency. In part 1 of this 2-part series, we provide specific strategies for the peg board, circle cut, and ligating loop tasks. Design Educational instructional video. Setting N/A Patients or Participants N/A Interventions FLS uses five simulation stations to assess basic laparoscopic surgery skills. It is a reliable and valid curriculum which has been shown to improve intraoperative trainee performance. It was developed in 2004, and since 2009 has been a requirement to qualify for the American Board of Surgery board certification. In 2018, the American Board of Obstetrics and Gynecology (ABOG) announced that FLS will be a prerequisite for specialty board certification for obstetrics and gynecology residents graduating after May 2020. ABOG states that this will “ensure that diplomates possess critical skills for the contemporary practice of obstetrics and gynecology.” Measurements and Main Results N/A Conclusion FLS is now a requirement for all OB/GYN residencies. Mastering the skills requires time and effort on the part of the learners but using these pro tips can help gain confidence and improve efficiency.

Effect of Motor Skill Training on Balance and Hand – Eye Coordination in Children with Attention Deficit Hyperactivity Disorder (ADHD)

Background: ADHD or Attention Deficit Hyperactive disorder is one of the most common condition affecting children. It is a neuro behavioural disorder affecting boys more than girls with a ratio of 3:1 and it affects almost 3 to 6 percentage of school children. There are limited number of studies on motor skill training to improve attention, balance and hand eye coordination. Methodology: Quasi Experimental, Convenient sampling, sample size was 30. The Participants for the study were selected based on the inclusion and exclusion criteria and experimental group followed 6 weeks of motor skill training exercise along with conventional physiotherapy. Conclusion: The results of this study showed post-test values of paediatric balance scale, nine-hole peg board test and gross motor functional measure of experimental and control group has a p value < 0.05 which is statistically significant. The study concludes that, motor skill training on attention deficit hyperactivity disorder shows significant improvement in balance and hand eye coordination.

Yaşlı Bireylerde Üst Ekstremite Fonksiyonları ile Denge Arasındaki İlişkinin İncelenmesi

Yaşlı bireylerde üst ekstremite fonksiyonlarını ve dengeyi ayrı ayrı inceleyen birçok çalışma bulunmasına rağmen, üst ekstremite fonksiyonları ile denge arasındaki ilişkiyi inceleyen çalışmaların yetersiz olduğu tespit edilmiştir. Bu çalışmanın amacı yaşlı bireylerde üst ekstremite fonksiyonları ile denge arasındaki ilişkiyi incelemektir. Bu çalışmaya yaşları 65 ve üzeri olan 80 yaşlı birey dahil edilmiştir. Bireylerin üst ekstremite fonksiyonlarını değerlendirmek için Jamar El Dinamometresi, 9 Delikli Peg Testi ve purdue peg board testi kullanılmıştır. Bireylerin dengelerini değerlendirmek için Berg Denge Ölçeği, Tinetti Denge ve Yürüme Testi, Biodex Denge Sistemi ve Tek Ayak Üzerinde Durma Testi kullanılmıştır. Bireylerin Jamar El Dinamometresi, 9 Delikli Peg Testi ve purdue peg board testi ile Berg Denge Ölçeği, Tinetti Denge ve Yürüme Testi, Biodex Denge Sistemi ve Tek Ayak Üzerinde Durma Testi aralarında anlamlı ilişki bulunmuştur (p<0,05). Bu çalışmanın sonunda üst ekstremite fonksiyonları ile denge arasında ilişki olduğu tespit edilmiştir. Yaşlı bireylerde üst ekstremite fonksiyonları ile ilgili kavrama kuvvetini, el becerilerini arttıran yaklaşımların bozulan denge ve buna bağlı günlük yaşam aktivitelerinde yaşanan sorunlar için yararlı olacağını düşünmekteyiz.

Reference value for the six-minute peg board and ring test. A cross sectional study.

IntroductionIn our daily life, arm activities, whether supported or unsupported play a major role. Both simple and complex activities require the muscles, namely trapezius, pectoralis minor, scalene, and intercostals, to participate in arm positioning. These muscles also enact as the accessory respiratory muscles. Therefore, arm elevation increases the load on these muscles and they fail to perform dual activities, resulting in arm fatigue and a feeling of dyspnoea in healthy individuals as well as in chronic obstructive pulmonary disease patients. Various upper limb exercise tests were designed to measure this impairment, one of them being the six-minute peg board and ring test. The aim of the study is to derive a reference value for the six-minute peg board and ring test among healthy Indian population (Mangalore) from the age of 20-70 years of either gender. Also, to find a correlation among the number of rings and body mass index, arm length, arm and forearm circumference, the strength of shoulder and elbow flexors-extensors, grip strength of both sides and level of physical activity.MethodsParticipants performed two tests, thirty minutes apart. They were asked to load as many rings as possible in 6 minutes. Arm length, arm and forearm circumference were measured with a measuring tape. Shoulder and elbow flexors-extensors were assessed using a handheld push-pull dynamometer. Grip strength was measured with the Jamar hand-held dynamometer. Level of physical activity was assessed using International Physical Activity Questionnairelong form.ResultsThe samples consisted of 450 healthy individuals between the age of 20-70 years. Reference values for each age group for both genders were reported. We found that age was correlated with the six-minute peg board and ring test score (p<0.05). We also found a correlation between the strength variables and the test results (p=0.001). However, no correlation was found between the arm length, arm and forearm circumference and the level of physical activity with the number of rings.ConclusionIn this study, we derived a reference value for the six-minute peg board and ring test. There was a correlation among age, strength variables and the number of rings.

Dance improves symptoms, functional mobility and fine manual dexterity in people with Parkinson disease: a quasi-experimental controlled efficacy study.

Clinically, individuals diagnosed with Parkinson disease (PD) present several symptoms that impact on their functional independence and quality of life. While there is accumulating evidence supporting dance as an effective symptom management option, few studies have objectively assessed these benefits, particularly related to the Dance for Parkinson's Disease® (DfPD®) program. The aim of this study was to explore the effects of DfPD®-based dance classes on disease-related symptoms, fine-manual dexterity and functional mobility in people with PD. A quasi-experimental controlled efficacy study, with pre and post testing of two parallel groups (dance versus control). Community. Thirty-three participants with PD allocated to one of two groups: dance group (DG; N.=17; age=65.8±11.7 years) or control group (CG: N.=16; age=67.0±7.7 years). They were cognitively intact (Addenbrooke's Score: DG=93.2±3.6, CG=92.6±4.3) and in early-stage of disease (Hoehn & Yahr: DG=1.6±0.7, CG=1.5±0.8). The DG undertook a one-hour DfPD®-based class, twice weekly for 12 weeks. The CG had treatment as usual. Both groups were assessed at baseline and after 12 weeks on disease-related symptom severity (MDS-Unified Parkinson Disease Rating Scale: MDS-UPDRS), fine-manual dexterity (Perdue Peg Board), measures of functional mobility (Timed Up & Go: single & dual task, Tinetti, Berg, Mini-BESTest) and self-rated balance and gait questionnaires (Activities Balance Confidence Scale: ABC-S; Gait and Falls: G&F-Q; Freezing of Gait: FOG). Compared to the CG, there was significantly greater improvement in the DG pre-post change scores on measures of symptom severity MDS-UPDRS, dexterity, six measures of functional mobility, and the ABC-S, G&F-Q, FOG questionnaires. DfPD®-based dance classes improved disease-related symptom severity, fine-manual dexterity, and functional mobility. Feasibility of the approach for a large scale RCT was also confirmed. DfPD® could be an effective supportive therapy for the management of symptoms and functional abilities in PD.

Another New Design for an Old Map

Another New Design for an Old Map

The impact of homocysteine, B12, and D vitamins levels on functional neurocognitive performance in HIV-positive subjects

BackgroundThe correlation among high levels of total homocysteine, low levels of B12vitamin, and neurocognitive impairment in HIV negative patients has been the main research topic in some of the latest reviews. The aim of this study was to examine if the alteration of homocysteine, B12 vitamin, and D vitamins plasma levels was present in HIV-positive, and their relationship with cognitive function.Methods57 HIV infected were enrolled and underwent the serum measurement of homocysteine, B12, and D vitamins. The neurocognitive evaluation investigated 5 cognitive domains, through a neuropsychological battery testResultsHomocysteine was found to be elevated in 70.2% of cases, B12 vitamin mean levels were low in 8 participants (14.0%), and 8 patients had D hypovitaminosis (14.0%). Abnormal homocysteine levels were associated with worse performance of verbal fluency (p = 0.003) and worse executive function (Stroop E test p = 0.040). The 25-OH D hypovitaminosis was associated with worse performances in executive functions in three different tests: Stroop E (p = 0.049), Trail B (p = 0.035), and Wais Digit Span (p = 0.042). Pathological levels of B12 Vitamin were also associated to worse performances in executive functions (Trail B Test and Wais Digit Span respectively p = 0.002 and 0.029) and with a lower speed in psychomotor processing (Peg Board Test on dominant hand, p = 0.014).ConclusionsIn this study serum homocysteine, B12, and D vitamin levels are associated with neurocognitive performances; in fact low performance neurocognitive was correlated with hyperhomocysteine and low B12vitamin, and D vitamin levels. Evidence of the alteration of these parameters could facilitate the early identification of a neurocognitive impairment.

Deficits in executive function and suppression of default mode network in obesity.

Although nutritional and metabolic factors are well established in obesity, neurocognitive determinants are less understood. Using data from the Human Connectome Project, this study concurrently investigated neurocognitive performance, neural activation during a working memory task, and cortical brain morphometry in relation to obesity in a group of young adults, 22-35 years old. Using a case-control design, obese individuals (n = 243, body mass index [BMI] ≥ 30 kg/m2) were compared to a control group of lean BMI individuals (n = 469, BMI = 18-24.9 kg/m2). Performance tests comprised a battery of behavioral neurocognitive assessments. Neural activity was measured as blood-oxygenation-level-dependent (BOLD) activity during an N-Back task using functional magnetic resonance imaging (fMRI). Cortical morphometry included indices of volume, thickness, and surface area. Relative to the control group, the obese group exhibited significantly worse performance in terms of the National Institutes of Health Toolkit (NIH) 9-Hole Peg Board, Penn Working Memory Test, Delay Discounting, Penn Progressive Matrices, NIH Picture Vocabulary Test, Dimensional Change Card Sort Test and the in-scanner N-Back working memory test (FDR-corrected ps<0.05;ds = 0.231-0.405). The obese group also exhibited significantly greater BOLD activation in N-Back task-negative regions, including the ventromedial prefrontal cortex, posterior cingulate, and right precentral gyrus (FDR-corrected ps<0.05). Supplemental functional connectivity analyses provided evidence that the implicated regions were part of the default mode network. Significant differences in morphometry were present in the medial orbitofrontal cortex, rostral anterior cingulate cortex, inferior and superior parietal gyri, and temporal pole (FDR-corrected p<0.001). A data-driven integrative model classified 73.8% of participants correctly. This multimodal investigation suggests diverse aspects of neurocognition are associated with obesity, particularly implicating deficits in executive function and ineffective suppression of the default mode network.

Psychomotor recovery of dexmedetomidine compared with propofol after sedation during spinal anesthesia: A randomized control trial.

Background and Aims:Early psychomotor recovery is an essential part of day care surgery which depends on brain integration of motor and sensory co-ordination. Even though dexmedetomidine is commonly used for day care procedures, the recovery profile was not studied. Hence, this study was designed to evaluate the psychomotor recovery of sedation with dexmedetomidine during spinal anesthesia.Material and Methods:Sixty-six patients were included. Group D received dexmedetomidine 0.5 μg/kg (loading dose) followed by 0.2–1 μg/kg/hour. Group P received propofol infusion of 25–100 μg/kg/minute. Psychomotor recovery was assessed by finger-tapping, manual dexterity, visual spatial memory capacity, and pen and paper tests. Psychomotor tasks were given to the patients postoperatively at every 30 minutes for 2 hours followed by every hour up to 4 hours after surgery. Distribution of patients, age, weight, duration of surgery, and the level of sensory blockade was compared using independent t-test. Student's t-test has been used to find the significance of parameters such as heart rate, mean arterial pressure, oxygen saturation (SpO2), psychomotor recovery between two groups. P < 0.05 was considered as significant.Results:The motor recovery using finger tapping test was faster in Group D than Group P (73.94 ± 42.13 vs 101.21 ± 37.98 minutes, P–value = 0.007). Motor recovery using peg board test was faster in Group P than Group D (82.12 ± 40.37 vs 99.39 ± 43.08 minutes, P–value = 0.098). Visual spatial capacity memory test and pen and paper test were unaffected.Conclusions:We conclude that patients who received dexmedetomidine showed earlier recovery with finger tapping test. Hence, we suggest to use dexmedetomidine for complete psychomotor recovery and fast-track discharging of the patient after spinal anesthesia.

Initial and Long-term Retention of Robotic Technical Skills in an Otolaryngology Residency Program.

To objectively assess the initial and long-term retention of robotic surgical skills of otolaryngology residents. This study was performed in an academic otolaryngology residency training program. Between October 2015 and November 2016, residents were invited to complete a prospective, multiphase robotic surgical skills training course: 1) online da Vinci Surgical System Assessment and didactic, 2) faculty-supervised robotic simulator training, 3) robotic docking and draping training, 4) robotic dry-lab exercises. To optimize surgical skill retention, the training laboratory was repeated 2 weeks after the initial training session. Twenty otolaryngology residents were included. Primary outcome was measured as robotic skill assessment scores on three tasks: camera targeting, peg board, and needle targeting. Skill assessments were completed prior to training, between the two training sessions, and at 1 month and 6 months after training. Residents were also asked to complete a self-assessment questionnaire. Camera targeting scores were improved at midtraining (P < .001) and 1-month posttraining (P = .010). Peg board scores were improved at 1 month training (P = .043). Needle targeting scores were improved at midtraining (P = .002), 1 month (P = .002), and 6 months posttraining (P < .001). Resident self-assessment scores demonstrating comfort with using the robotic console (P < .01) and docking/draping (P < .01) improved significantly following the training. Following a multiphase robotic training program, otolaryngology residents demonstrated significant, objective skill acquisition and retention at 1 month and 6 months follow-up. Although the proposed training strategy may be considered an important step in otolaryngology residency training, additional innovations are being designed toward a formal robotic training curriculum. NA Laryngoscope, 129:1380-1385, 2019.

Using Robotics to Quantify Impairments in Sensorimotor Ability, Visuospatial Attention, Working Memory, and Executive Function After Traumatic Brain Injury.

To investigate the use of a robotic assessment tool to quantify sensorimotor, visuospatial attention, and executive function impairments in individuals with traumatic brain injury (TBI). Foothills Hospital (Calgary, Canada). Twenty-three subjects with first-time TBI in the subacute to chronic phase participated in this study. Normative data were collected from 275 to 494 neurologically intact control subjects for each robotic task. A prospective observational case series. Subjects with TBI completed brief clinical cognitive and motor assessments followed by robotic assessments of upper limb reaching, position sense, bimanual motor ability, attention, and visuospatial skills. Scores of subjects with TBI were compared with normative data. Robotic task performance was computed for each subject on each task, as well as performance on specific task parameters. Clinical assessments included the Montreal Cognitive Assessment, Fugl-Meyer upper extremity assessment, and Purdue Peg Board. Subjects with TBI demonstrated a variety of deficits on robotic tasks. The proportion of TBI subjects who were significantly different from controls ranged from 36% (dominant arm reaching) to 60% (bimanual object hitting task). Robotic measures allowed us to quantify a range of impairments specific to each subject, and offer an objective tool with which to examine these abilities after TBI.

Skills in minimally invasive and open surgery show limited transferability to robotic surgery: results from a prospective study.

There is limited evidence on the transferability of conventional laparoscopic and open surgical skills to robotic-assisted surgery. The primary aim of this study was to evaluate the transferability of expertise in conventional laparoscopy and open surgery to robotic-assisted surgery using the da Vinci Skills Simulator (dVSS). Secondary aims included evaluating the influence of individual participants' characteristics. Participants performed four tasks on the dVSS: Peg Board 1 (PB), Pick and Place (PP), Thread the Rings (TR), and Suture Sponge 1 (SS). Participants were classified into three groups (Novice, Intermediate, Experts) according to experience in laparoscopic and open surgery. All tasks were performed twice except for SS. Performance was assessed using the built-in scoring system. 37 medical students and 25 surgeons participated. Experts did not perform significantly better than less experienced participants on the dVSS. Specifically, with regard to laparoscopic experience, total simulator scores were: Novices 68.2 ± 28.8; Intermediates 65.1 ± 31.2; Experts 65.1 ± 30.0; p = 0.611. Regarding open surgical experience, scores were: Novices 68.6 ± 28.7; Intermediates 68.2 ± 30.8; Experts 63.2 ± 30.3; p = 0.305. Although there were some significant differences among groups for single parameters in specific tasks, there was no constant superiority of one group. Laparoscopic and open surgical Novices improved significantly in overall score and time for all three tasks (p < 0.05). Laparoscopic intermediates improved only in PP time (4.64 ± 3.42; p = 0.006), open Intermediates in PB score (11.98 ± 13.01; p = 0.025), and open Experts in PP score (6.69 ± 11.48; p = 0.048). Laparoscopic experts showed no improvement. Participants with gaming experience had better overall scores than non-gamers when comparing all second attempts (Gamer 83.62 ± 7.57; Non-Gamer 76.31 ± 12.78; p = 0.008) as well as first and second attempts together (Gamer 72.08 ± 8.86; Non-Gamer 65.45 ± 11.68; p = 0.039). Musical and sports experience showed no correlation with robotic performance. Robotic-assisted surgery requires skills distinct from conventional laparoscopy or open surgery. Basic robotic skills training prior to patient contact should be required.

Does previous open surgical experience have any influence on robotic surgery simulation exercises?

IntroductionWithin the last years, there has been a trend in many hospitals to switch their surgical activity from open/laparoscopic procedures to robotic surgery. Some open surgeons have been shifting their activity to robotic surgery. It is still unclear whether there is a transfer of open surgical skills to robotic ones.AimTo evaluate whether such transfer of skills occurs and to identify which specific skills are more significantly transferred from the operative table to the console.Material and methodsTwenty-five volunteers were included in the study, divided into 2 groups: group A (15 participants) – medical students (without any surgical experience in open, laparoscopic or robotic surgery); and group B (10 participants) – surgeons with exclusively open surgical experience, without any previous laparoscopic or robotic experience. Participants were asked to complete 3 robotic simulator console exercises structured from the easiest one (Peg Board) to the toughest one (Sponge Suture). Overall scores for each exercise as well as specific metrics were compared between the two groups.ResultsThere were no significant differences between overall scores of the two groups for the easiest task. Overall scores were better for group B as the exercises got more complex. For the intermediate and high-difficulty level exercises, most of the specific metrics were better for group B, with the exception of the working master space item.ConclusionsOur results suggest that the open surgical skills transfer to robotic skills, at least for the very beginning of the training process.

Does Previous Laparoscopic Experience Influence Basic Robotic Surgical Skills?

Studies addressing the effect of laparoscopic experience on robotic skills have produced conflicting results. This study aimed to compare simulated robotic surgical tasks using the virtual reality simulator dV-Trainer between laparoscopically experienced surgeons and first-year surgical residents. A cross-sectional study. Participants completed 4 trials of the following tasks on the dV-Trainer: Peg Board 2, Ring and Rail 1, and Suture Sponge 1. Performance was recorded using a computerized built-in scoring algorithm. Scores and metrics were compared between groups 1 and 2 and between the first and subsequent trials. Hospital de Clínicas, Porto Alegre, Brazil, a tertiary care teaching hospital. Twenty laparoscopically experienced surgeons (group 1) and 20 first-year surgical residents (group 2). All participants completed the study. The overall scores for Peg Board 2 (738.04 ± 267.83 vs 730.39 ± 225.31; p = 0.57), Ring and Rail 1 (919.03 ± 242.69 vs 965.84 ± 222.96; p = 0.13), and Suture Sponge 1 (563.62 ± 185.50 vs 560.99 ± 152.71; p = 0.67) did not differ significantly between groups 1 and 2. Group 1 had better results for master workspace range in Peg Board 2 and Ring and Rail 1. Group 2 had higher scores for economy of motion in Peg Board 2 and Ring and Rail 1 and for excessive instrument force in Ring and Rail 1. In both groups, the overall scores in the third and fourth trials were significantly higher than those in the first trial. There are no significant differences in the performance of simulated robotic surgical tasks between laparoscopically experienced surgeons and laparoscopically naïve surgical residents. Some slight differences were observed in specific metrics, but these differences were not sufficient to change the final results. We may assume that laparoscopic experience should not be an essential step in the initial learning curve of robotic surgery.

Effect of hand grip exercise on finger dexterity in geriatric population using nine-hole peg board test: A pilot study

Effect of hand grip exercise on finger dexterity in geriatric population using nine-hole peg board test: A pilot study