aod

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I'm a second year that is interested in surgery - but unfortunately I'm still stuck in lecture all day and studying for step 1 at night.

Does anyone know of some simple exercises to improve manual dexterity that can be done while studying, in lecture, etc.? Pen spinning is played out.

Thanks,
 

aboo-ali-sina

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absolutely agree. Tying is the key. Master two handed tying before you try one handed. It will put you ahead of the curve during your sugery rotation. The only technical thing you are expected to ba able to do as a third year medical student is the two handed tie.
 
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Astroman

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Yeah, but you can't really tie knots while studying. Ask an OR tech to give you a beat-up needle driver and practice palming it (opening and closing it without using the "holes")... Very easy to do while studying.

Plus, later put 'em in your white coat pocket and it gives you something to do discretely while on excruciatingly long and painful medicine rounds.
 

maxheadroom

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Good to be able to palm the instruments, but also practice with your fingers in the loops. Some surgeons demand that you use them.

My school had all of the notes transcribed, so I didn't take many notes in lecture. This left me free to sit there and tie while listening.
 
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Blade28

Absolutely, tying knots and learning how to hold instruments is key.

You can easily practice in lecture.
 
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Blade28

Just had a thought (as I was playing poker with friends recently)...how about chip tricks? :)
 

maxheadroom

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once you get to the point where you can hand tie prolene that's been greased while double-gloved, then branch out to other tricks (chip tricks, pencil spinning, shower activities). Until then, tie hundreds and hundreds of knots. R hand dominant and L hand dominant. Surgeon's knots (double throws on the first throw).
 

aboo-ali-sina

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another thing, learn to tie one handed knots with your non-dominant hand. This way you don't have to let go of the needle driver to tie your knot. And so you can anchor your running suture line and go straight into running your suture without stuttering.

That is totally hollywood :)
 
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Blade28

doc05 said:
no point. it's all about muscle memory. just practice tying.
I know. :) I had my OB/GYN rotation before Surgery (on purpose), so I'd be exposed to the sterile field, get to practice tying/suturing, etc. first. I didn't want to look like an idiot during my Surgery rotation.

I agree with the above posts...practice, practice, practice one- and two-handed ties (both ways, left hand dominant and right hand dominant). I also practiced palming, opening and closing needle drivers with both hands, as well as instrument ties.

Eventually, you'll be able to do everything without looking. :thumbup:
 

dr.evil

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I guess if you were bored out of your mind, the ideal knot tying practice would be double gloved with your gloves coated in Vaseline (but not in the shower :rolleyes: ) while tying 0 Prolene squarely, tightly, one handed, two handed. I'm almost in my third year of surgery residency and when my hands have been in a sea of fat, my gloves are so slick that Prolene is evil.
 

aboo-ali-sina

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dr.evil said:
I guess if you were bored out of your mind, the ideal knot tying practice would be double gloved with your gloves coated in Vaseline (but not in the shower :rolleyes: ) while tying 0 Prolene squarely, tightly, one handed, two handed. I'm almost in my third year of surgery residency and when my hands have been in a sea of fat, my gloves are so slick that Prolene is evil.
no no... prolene did not spend 6 years in evil medical school to be called just Evil

Thank you very much! :)
 

jakstat33

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Astroman said:
Yeah, but you can't really tie knots while studying. Ask an OR tech to give you a beat-up needle driver and practice palming it (opening and closing it without using the "holes")... Very easy to do while studying.

Plus, later put 'em in your white coat pocket and it gives you something to do discretely while on excruciatingly long and painful medicine rounds.
can ya'll elaborate on palming... does not using the holes give you an advantage? why not use them?

-dude (where's my car)
 

aboo-ali-sina

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when you palm the driver, you have an increase in the range of motion of the tool because not only can you utilize the full ROM of your wrist, but also you can move the driver in your palm in several directions.

Furthermore, it makes it easier to do running sutures because you can grab your needle, place it through the tissue, then grab it on the other side of the tissue, and then flip the driver 180 degrees in your palm and your are ready to place your next bite. As you get good with this, you can also manipulate the angle of the needle and it's backhand or forehand position all with simple wrist manipulations.

All these advantages can save you time and probable most important of all:

MAKE YOU LOOK HOLLYWOOD

That being said, as a student (or an intern for that matter) it is more important to do what your attendings and senior residents want you to do than to hot dog it with these tricks. So if your attending wants you to use the finger holes, use them.

An aside, unlike the finger holes in needle drivers, the finger holes in scissors should always be used, especially when cutting near critical structures; otherwise you can not control the scissors effectively (or safely... ooops, did you want me to cut the ends of your stitch or cut a hole into the aorta?)
 

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At what point should a med student even begin learning suture/knot-tying techniques? And where are these techniques described?
 

DoctorDoom

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Jamaican MD said:
At what point should a med student even begin learning suture/knot=tying techniques? And where are these techniques described?
Sometime before your surgical or OB rotations, or even dutring, start practicing. Most surgery textbooks will have some information on sutures and knot tying. Ethicon also has free manuals and, I believe, even practice kits.

http://www.jnjgateway.com/public/USENG/Knot_Tying_Manual.pdf

Start practicing with thick threads, like shoelaces, then move on to suture material. Takes a little bit but it's easy with practice.
 
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I just want to congratulate everyone for their thoughtful answers. I can't believe this thread has gone so long without SOMEONE posting something funny, considering the OP is titled "Manual dexterity exercises".

;)

(Let the games ....BEGIN!)
 

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kinetic said:
I just want to congratulate everyone for their thoughtful answers. I can't believe this thread has gone so long without SOMEONE posting something funny, considering the OP is titled "Manual dexterity exercises".

;)

(Let the games ....BEGIN!)
You can try to improve your manual dexterity by pleasuring all of your friend's mothers. That way you can get instant feedback about how dextrous your hands are.
 

Hotsauce21

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I cant believe no one has touched on this, but it is a fairly well known fact that endoscopists are generally better nowadays because of one thing:
Video games. People are much quicker to learn procedures now.
They just had a study that showed that physicians who play 3 hrs of video games per week are better endoscopists. There was nothing directly indicating the same for surgeons, but I would assume that its better for surgeons as well.
jj
 

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what a fantastic thread!

people in this forum are so much more helpful and mature than the pre-allo forum.

thanks guy :thumbup: :thumbup: :thumbup:

especially dr. doom
 

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Actually there is a study out about those residents that do some sort of video gaming before surgery for manual dexterity tend to be more skilled surgeons. So start playing video games. It's actually true...
 

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what instruments exactly did you practice palming in lecture?

-J
 
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DoctorDoom

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SOUNDMAN said:
Actually there is a study out about those residents that do some sort of video gaming before surgery for manual dexterity tend to be more skilled surgeons. So start playing video games. It's actually true...
One study showed that residents, who are still in the middle of the learning curve for lap, seemed to have greater ease with laparoscopic procedures. Just one. Best way to be a good surgeon is to do the procedures. Unfortunately Splinter Cell isn't a real shortcut!
 
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Sahani

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DoctorDoom said:
Ethicon phone number for free suture practice board and materials:

1-800-255-2500
Dr. Doom, thanks a lot! I was nosing around away from my usual MCAT Pre-med forum, and was really impressed by this. It is certainly more mature, and I guess my knot tying board will come at the same time my mcat scores do... Hopefully I'm practicing later, rather than throwing the board against the wall.

Thanks again!
 

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Here's a study from USA Today which showed that "Researchers found that doctors who spent at least three hours a week playing video games made about 37% less mistakes in laparoscopic surgery and performed the task 27% faster than their counterparts who did not play video games."

http://www.usatoday.com/tech/news/2004-04-07-surgeons-video-games_x.htm

I can't wait for Halo 2. Now I'll have an excuse to play while I'm in school. Thanks microsoft :D
 

DocLandry

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wonder if that would help with malpractice...hmmm
 

SOUNDMAN

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DoctorDoom said:
One study showed that residents, who are still in the middle of the learning curve for lap, seemed to have greater ease with laparoscopic procedures. Just one. Best way to be a good surgeon is to do the procedures. Unfortunately Splinter Cell isn't a real shortcut!
I know that's why I play TFC from half-life instead. Much more dexterity required there :)
 

Shades McCool

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DoctorDoom said:
Ethicon phone number for free suture practice board and materials:

1-800-255-2500
Do you just call and ask for one?
 

Shades McCool

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Bump
 

Deanis

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So this post is oooold, but I was wondering if it is still possible to get my hands on some practice materials, specifically the ethicon practice board. I checked out their website and couldn't find it, so it's quite likely they aren't available anymore. It used to be you could get some stuff to practice on for free.

I know I can buy some cheap needle drivers/holders on ebay, as well as suture material, but what I would really like is instructions, videos, etc. on different techniques. youtube has some, but I was hoping for a bit more.

Thanks.
 

Winged Scapula

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So this post is oooold, but I was wondering if it is still possible to get my hands on some practice materials, specifically the ethicon practice board. I checked out their website and couldn't find it, so it's quite likely they aren't available anymore. It used to be you could get some stuff to practice on for free.

I know I can buy some cheap needle drivers/holders on ebay, as well as suture material, but what I would really like is instructions, videos, etc. on different techniques. youtube has some, but I was hoping for a bit more.

Thanks.
Are you really a pre-med?

If so, I'd suggest you wait until you get to medical school, borrow some old needle drivers and outdated suture material and have a resident or attending teach you. I don't see much purpose in practicing now.

Otherwise, AFAIK, the Ethicon board is still available if you call.
 

smq123

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So this post is oooold, but I was wondering if it is still possible to get my hands on some practice materials, specifically the ethicon practice board. I checked out their website and couldn't find it, so it's quite likely they aren't available anymore. It used to be you could get some stuff to practice on for free.

I know I can buy some cheap needle drivers/holders on ebay, as well as suture material, but what I would really like is instructions, videos, etc. on different techniques. youtube has some, but I was hoping for a bit more.

Thanks.
I never found the Ethicon practice board to be much better than practicing on a chair leg or something like that.

Just get thick rope or string (or dental floss, if you want to simulate the thickness of actual suture), and practice.

There are some good practice videos on different websites. BU has a great one, but I don't remember the link off the top of my head.

Either way, it's too early to worry about it now, as Winged Scapula said. Worry about it as an MS2 or an MS3. Tying knots is not all that hard, and can easily be learned. I never wanted to do surgery until MS3, so I had to learn everything (suturing, knot tying, sterile technique) on my OB and surgery rotations. I never had any problems, and passed the practical part of the surgery exam with flying colors.
 

Deanis

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Thanks.

As both of you point out, it's too early to worry about it for me. But I'm not really worried about it. I just think it'd be, well, fun to do while watching a movie, listening to music, taking a dump... I'm not trying to beat the curve. It just seems, well, neat. (Yes, I realise that puts me in the full out nerd camp). Some people knit or whatever whilst doing mindless activites so why the hell knot?

PS: What's BU?
 

smq123

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As both of you point out, it's too early to worry about it for me. But I'm not really worried about it. I just think it'd be, well, fun to do while watching a movie, listening to music, taking a dump... I'm not trying to beat the curve. It just seems, well, neat. (Yes, I realise that puts me in the full out nerd camp). Some people knit or whatever whilst doing mindless activites so why the hell knot?
No....wanting to learn how to tie surgical knots doesn't put you in the "full out nerd camp."

The pun that you made at the end does, however. ;) (I'm teasing.)

PS: What's BU?
Boston University.

I found the link, by the way: http://www.bumc.bu.edu/generalsurgery/technical-training/basic-knot-tying-suturing/

Hope you find it fun. :)
 
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Blade28

It's definitely a little early to be worrying about this. I didn't start learning how to tie until my MS-III year so you're about 3+ years early. :)
 

Deanis

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Actually, I'm 31 and will *hopefully* be starting medical school next August. So I'd say I'm a good 5 or so years late ;)
 
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