How do surgeons have steady hands ?

[Derrick]

I'm just wondering..
Do they do some tricks? like resting their hands while operating ?
or it's something that all surgeons have naturally?
And If my hands shakes a little bit (maybe 1-2 mm) can I be a successful surgeon ?

Thanks.

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[futuresurgeon00]

I assume it comes with practice, but since this is the pre-med forum....you might want to ask this in one of the medical forums...then, actual surgical attendings, fellows or residents would be able to answer your question, with the right answer.

 

[Winged Scapula]

I assume it comes with practice, but since this is the pre-med forum....you might want to ask this in one of the medical forums...then, actual surgical attendings, fellows or residents would be able to answer your question, with the right answer.

Actually that's incorrect. The specialty forums are for questions of interest to residents/fellows/attendings in those specialties. Any question asked by a pre-med or medical student gets moved right back to those forums.

Honestly, we come here to look for questions we can answer, so this is the proper place.

Ok...tremors.

Everyone's got them. Even surgeons. My hands are pretty steady (I don't see a tremor) but as one of my attendings used to say, "we all have tremors, I just don't want to know how much of one you have".

The "tricks" to hiding them?

- cut back on caffeine and other stimulants
- try to not be nervous (easier said than done and when in residency, I was always nervous with a new attending and my hands would shake)
- beta blockers if really bad
- resting your hand on the patient
- using the correct size instruments

In the vast majority of cases a normal resting tremor is not going to preclude you from being a surgeon; heck, even a significant tremor doesn't in most cases. Microvascular work? That's an issue but so few people do that work, that its not going to be a problem for most people.

All in all, a tremor is normal. Everyone has one. It won't stop you from being a surgeon as long as you can control it to some degree.

 

[futuresurgeon00]

Sorry about the wrong information...I honestly didn't know that...Thanks anyway for correcting me...

 

[Winged Scapula]

Sorry about the wrong information...I honestly didn't know that...Thanks anyway for correcting me...

No worries...common misconception. We spend a lot of time moving stuff around.

 

[khatz]

Actually that's incorrect. The specialty forums are for questions of interest to residents/fellows/attendings in those specialties. Any question asked by a pre-med or medical student gets moved right back to those forums.

Honestly, we come here to look for questions we can answer, so this is the proper place.

Ok...tremors.

Everyone's got them. Even surgeons. My hands are pretty steady (I don't see a tremor) but as one of my attendings used to say, "we all have tremors, I just don't want to know how much of one you have".

The "tricks" to hiding them?

- cut back on caffeine and other stimulants
- try to not be nervous (easier said than done and when in residency, I was always nervous with a new attending and my hands would shake)
- beta blockers if really bad
- resting your hand on the patient
- using the correct size instruments

In the vast majority of cases a normal resting tremor is not going to preclude you from being a surgeon; heck, even a significant tremor doesn't in most cases. Microvascular work? That's an issue but so few people do that work, that its not going to be a problem for most people.

All in all, a tremor is normal. Everyone has one. It won't stop you from being a surgeon as long as you can control it to some degree.

My hands are pretty shaky, always been like that for some reason. The only way I have steady hands is to sort've pressure/grip them while holding something. Are your hands required to be loose during surgery? How bad of a mistake could you make by having the occasional tremor?

 

[Winged Scapula]

My hands are pretty shaky, always been like that for some reason. The only way I have steady hands is to sort've pressure/grip them while holding something. Are your hands required to be loose during surgery?

I'm not sure what you mean by loose. Typically you are operating with two hands; for example, forceps in one hand, electrocautery or scalpel in another. I find it hard to operate without holding something in my hands LOL.

How bad of a mistake could you make by having the occasional tremor?

Depends.

1) how shaky is "pretty shaky"

2) where you're operating; ie, if you're operating near a major vessel or nerve you could cause some serious damage

3) what you have in your hands when near above noted vital structures; it can be a lot more dangerous to have a significant tremor and be holding a scapel or cautery near a major vessel than it is when holding the suction

There's no way to tell whether or not your tremor is going to prevent you from being a surgeon. You may find you don't even want to be a surgeon when you get to the point of deciding. The pool of individuals who make it all the way is very small:

HS students wanting to go into medicine -> HS students getting into college -> College students who are pre-med who actually get into medical school -> medical students who say them want to be surgeons - > medical students who actually like surgery when they do it -> medical students who apply and match into a surgery residency - > surgical residents who don't quit (about 20% attrition rate)

 

[khatz]

I'm not sure what you mean by loose. Typically you are operating with two hands; for example, forceps in one hand, electrocautery or scalpel in another. I find it hard to operate without holding something in my hands LOL.



Depends.

1) how shaky is "pretty shaky"

2) where you're operating; ie, if you're operating near a major vessel or nerve you could cause some serious damage

3) what you have in your hands when near above noted vital structures; it can be a lot more dangerous to have a significant tremor and be holding a scapel or cautery near a major vessel than it is when holding the suction

There's no way to tell whether or not your tremor is going to prevent you from being a surgeon. You may find you don't even want to be a surgeon when you get to the point of deciding. The pool of individuals who make it all the way is very small:

HS students wanting to go into medicine -> HS students getting into college -> College students who are pre-med who actually get into medical school -> medical students who say them want to be surgeons - > medical students who actually like surgery when they do it -> medical students who apply and match into a surgery residency - > surgical residents who don't quit (about 20% attrition rate)

Maybe it's just me. If I'm gripping utensils, my hands aren't shaking, but, for instance, when I just loosely hold them, I get the shakes. I guess it's hard to explain, lol. Thanks for the insight though. I know surgery is a bit of a leap to think about at this stage but it's an interesting topic while we're on it.

 

[Winged Scapula]

Maybe it's just me. If I'm gripping utensils, my hands aren't shaking, but, for instance, when I just loosely hold them, I get the shakes. I guess it's hard to explain, lol. Thanks for the insight though. I know surgery is a bit of a leap to think about at this stage but it's an interesting topic while we're on it.

There's a physiologic reason for that.

When you are holding something loosely in your fingers you are basically relying on skin tension and even a certain amount of sweat to keep the object there. You aren't engaging the small muscles of the hand - hence the tremor is more visible and is physiologic (normal).

When actively using muscle contraction to hold on, such as when gripping something tight, you are less likely to manifest a resting tremor.

 

[khatz]

There's a physiologic reason for that.

When you are holding something loosely in your fingers you are basically relying on skin tension and even a certain amount of sweat to keep the object there. You aren't engaging the small muscles of the hand - hence the tremor is more visible and is physiologic (normal).

When actively using muscle contraction to hold on, such as when gripping something tight, you are less likely to manifest a resting tremor.

That's pretty interesting. I can imagine it's probably not a good idea to be actively applying tension to your hands and fingers during a surgery but likewise, a bad idea to be shaky as well.

 

[Winged Scapula]

That's pretty interesting. I can imagine it's probably not a good idea to be actively applying tension to your hands and fingers during a surgery but likewise, a bad idea to be shaky as well.

There has to be some muscular tension and contraction otherwise you wouldn't be able to hold the instruments.

Using the hands frequently does lend itself to RSI, Carpal Tunnel (just had mine done last week), arthritis, etc. Occupational hazard.