You have accessJournal of UrologyCME1 Apr 2023MP26-10 COULD FINGER ASSIGNMENT AT THE ROBOTIC CONSOLE IMPROVE SURGICAL EDUCATION AND ERGONOMICS OR CAUSE ANY ADVERSE EVENTS? A RANDOMIZED PROSPECTIVE BLINDED SIMULATION PILOT STUDY Zachary M. Connelly, Moss Matthew, Kevin Morgan, Alex Fuselier, Tomas Paneque, Harrison Torres, Mohamed Ahmed, MN Rochester, and Nazih Khater Zachary M. ConnellyZachary M. Connelly More articles by this author , Moss MatthewMoss Matthew More articles by this author , Kevin MorganKevin Morgan More articles by this author , Alex FuselierAlex Fuselier More articles by this author , Tomas PanequeTomas Paneque More articles by this author , Harrison TorresHarrison Torres More articles by this author , Mohamed AhmedMohamed Ahmed More articles by this author , MN RochesterMN Rochester More articles by this author , and Nazih KhaterNazih Khater More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003254.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robotic surgery has become a standard approach in urology. Greater range of motion may be attributed to the EndoWrist instruments that provide 7 degrees of freedom. This allows surgeons to gain precision and have fewer surgical complications. To our knowledge, no prior studies support one way to handle the controls at the surgical console. In our experience, volunteers report discomfort during wrist manipulation while using the thumb and middle finger (1&3). We hypothesize that using the thumb and index finger (1&2) will allow superior surgical proficiency via the Da Vinci Skills Simulator. METHODS: After IRB approval, we recruited 42 medical students across all 4 years in one university-based medical center. Each volunteer was given a standardized orientation. Students were then randomly assigned to start with their thumb and index finger (1&2) or (1&3). Two standardized modules were used with metrics calculated upon completion. These include: score, total time, economy of motion, efficiency score, collisions, inaccurate puncture, wound approximation, out of view, and penalty subtotal. Statistical analysis of the metrics was calculated using SPSS. RESULTS: Three were found to have statistically significant differences between the finger placement of 1&3compared to 1&2 (Figure 1). The number of collisions, wound approximation, and penalty score were all significant where 1&3 had a lower score in each. The number of collisions was 5.6 less in the 1&3 finger placement (p= 0.017). The wound approximation was 0.2 points smaller when using the 1&3 placement (p = 0.001). Lastly, the penalty assigned was 6.42 points lower when using 1&3 (p= 0.023). The overall score (p= 0.615), total time (p= 0.385), out of view (p=0.462), and economy of motion (p= 0.184) were not significant from one another. CONCLUSIONS: Although finger placement did not affect the overall score of the completed simulation, instrument collisions and unnecessary wound complications may lead to adverse outcomes. This may be due to decreased comfort in hand position resulting in a more cautious surgical approach. Better understanding of how finger placement can lead to decreased ergonomics and increased complications may shape robotic training. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e356 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zachary M. Connelly More articles by this author Moss Matthew More articles by this author Kevin Morgan More articles by this author Alex Fuselier More articles by this author Tomas Paneque More articles by this author Harrison Torres More articles by this author Mohamed Ahmed More articles by this author MN Rochester More articles by this author Nazih Khater More articles by this author Expand All Advertisement PDF downloadLoading ...