Training surgery as left-handed

Here, the instruments that can be used for suturing are presented. Some left-handed operators use instruments specifically designed for left-handed individuals, as shown here. Others have learned to use instruments designed for right-handed individuals.

The needle holder is handled with the dominant hand. To achieve the best ergonomics, the instrument is held with a three-point fixation, which makes the movements controlled. The two eyes of the needle holder are held with the thumb and ring finger, while the index finger rests along the shaft. This allows you to guide the needle holder with the middle finger, control it with the index finger, and guide the needle in a smooth motion using the wrist.

The needle holder has a built-in locking mechanism in the shaft, so it can be locked, thereby holding the needle firmly. The grip is unlocked when the needle needs to be released. On needle holders for left-handed individuals, this locking mechanism is reversed compared to instruments for right-handed individuals.

The anatomical forceps are handled with the non-dominant hand, resting along the index and middle fingers. The forceps can be squeezed together using the thumb and index finger. The tips of the forceps are cross-hatched for better grip.

The surgical forceps are handled like the anatomical forceps but differ in that the tips have sharp teeth, which can grasp and mobilize tissue.

The scissors are held with a three-point fixation, just like the needle holder. With scissors specially designed for left-handed individuals, it is much easier to cut the thread.

In this chapter, you’ll be guided in how to train surgical knots and square knots as a left-handed clinician, in a safe and dry environment. To start, we use a knot-tying trainer with large coloured bits of string, to make it clear when the right pattern is achieved in the knots. Then we move on to the more finicky surgical sutures and use a foam pad to simulate tissue. Finally, both the interrupted and continuous techniques are demonstrated on a labia repair model, to better simulate the right angle for an actual repair.

Because the complexity of real-life lacerations is much higher than what can be achieved in simulation training, we show examples of actual surgeries performed by a left-handed clinician.

Case 1 is repair of a grade 1 tear and a labial tears.

Case 2 is a 2nd-degree laceration, involving the bulbospongiosus muscle and the superficial transverse perineal muscle. The tear is repaired using a continuous technique, with stabilizing Aberdeen knots between the different anatomical layers.

Case 3 is another 2nd-degree laceration, involving the bulbospongiosus muscle and the superficial transverse perineal muscle. The tear is repaired using an interrupted technique.