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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Buschbacher RM (1999) Median 14-cm and 7-cm antidromic sensory studies to digits two and three. Am J Phys Med Rehabil 78: S53–S62
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: 1182–1189
Horgan LF, O’Riordan DC, Doctor N (1997) Neuropraxia following laparoscopic procedures: an occupational injury. Min Invas Ther Allied Technol 6: 33–35
Kano N, Yamakawa T, Ishikawa Y, Miyajima N, Ohtaki S, Kasugai H (1995) Prevention of laparoscopic surgeon’s thumb. Surg Endosc 9: 738–739
Kano N, Yamakawa T, Kasugai H (1993) Laparoscopic surgeon’s thumb. Arch Surg 128: 1172
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
Lowe JB III, Sen SK, Mackinnon SE (2002) Current approach to radial nerve paralysis. Plast Reconstr Surg 110: 1099–1113
Majeed AW, Jacob G, Reed MW, Johnson AG (1993) Laparoscopist’s thumb: an occupational hazard. Arch Surg 128: 357
Nasr JT, Kaufman MA (2001) Electrophysiologic finding in two patients with digital neuropathy of the thumb. Erectromyogr Clin Neurophysiol 41: 353–356
Neuhous SJ, Watoson DI (1997) Laparoscopic surgeons’ thumb: is it a training phenomenon? Min Invas Ther Allied Technol 6: 31–32
Sackier JM, Berci G (1992) A laparoscopic hazard for the surgeon. Br J Surg 79: 713
Seddon H (1975) Surgical disorders of peripheral nerves. 2nd ed. Churchill Livingstorne, Edinburgh
Seddon HJ (1943) Three types of nerve injury. Brain 66: 237
Woo JL, Yoon SC (2001) Superficial nerve damage of thumb of laparoscopic surgeon. Surg Laparosc Percutan Tech 11: 207–208
Zee DC, Bax NMA (1995) Digital nerve compression due to laparoscopic surgery. Surg Endosc 9: 740
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Inaki, N., Kanehira, E., Kinoshita, T. et al. Ringed silicon rubber attachment prevents laparoscopic surgeon’s thumb. Surg Endosc 21, 1126–1130 (2007). https://doi.org/10.1007/s00464-006-9061-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-006-9061-3