Tackling the conflict of handedness in SMILE: Lefties in training and their right-handed trainers
Sraddha Limbu, Vipasha Sharma, Chintan MalhotraBackground:
Left-handed (LH) surgical trainees often face practical disadvantages in predominantly right-handed (RH) operating environments. [1-3] They may feel extra pressure to become ambidextrous or even change their laterality. [1-3] RH trainers also experience difficulty in demonstrating and supervising procedures for LH trainees. [4] This challenge is crucial in techniques such as SMILE, where precise, coordinated movements are essential and early efficacious postoperative outcomes are desired.
Purpose:
To highlight the technical challenges arising from laterality differences between an RH trainer and an LH trainee during SMILE surgery and to present a practical modification to facilitate smoother trainer–trainee interaction.
Synopsis:
A dual side-cut incision strategy was used in all SMILE cases. Two cap incisions were created at 60° and 135°. The 60° incision served as the primary entry for the LH trainee, allowing comfortable manipulation with the dominant left hand. The 135° incision functioned as a rescue incision for the RH trainer, enabling seamless takeover with the dominant right hand when required. Although dual incisions have previously been described for purposes such as plane identification or pocket irrigation, [5] their use to address handedness conflicts in surgical training has not been reported.
Highlights:
This study addresses the challenge of trainer–trainee handedness disparity during SMILE surgery by introducing a dual-incision approach that accommodates both a left-handed trainee and a right-handed trainer. The technique provides a practical modification to surgical training without compromising the standard surgical workflow and enables seamless intraoperative transfer of surgical control whenever required.
Video link:
https://youtu.be/OGcO8lqyvJQ