Playing posture, instrument characteristics, and musculoskeletal pain among adolescent wind instrument players: an exploratory cross-sectional study.

Approximately 10.6% of the global population is left-handed [] with lower prevalence reported in China historically []. Left-handed surgeons face systemic ergonomic challenges in conventional right-oriented surgical environments encompassing instrument design, training paradigms, and procedural ergonomics [, ]. For instance, standardized liver palpation techniques requiring right-handed maneuvers contradict natural left-handed motor patterns, potentially compromising examination quality and risking academic penalties for noncompliance. Targeted medical education and training programs are essential. These programs include specialized ergonomic accommodations and simulation modules designed for left-handed individuals to tackle the unique psychomotor challenges these trainees face during skill acquisition and clinical practice [, ]. Predominantly right-handed–configured clinical curricula and instrumentation compel left-handed trainees to acquire procedural skills through non-dominant hand adaptation [, , ]. As a left-handed thoracic surgeon, I developed an optimized subxiphoid thoracoscopic thymectomy protocol to address this educational gap. The subxiphoid thoracoscopic approach has gained international acceptance [–], offering advantages over unilateral techniques including bilateral visualization and rapid recovery [, ]. The restricted mediastinal space fundamentally constrains subxiphoid surgical maneuvers, where optimizing the anterior pericardial-sternal distance becomes critical for procedural enhancement. The conventional operative technique requiring crossed manipulation of instruments both obstructs the field of vision and necessitates greater longitudinal operative space, consequently compounding the difficulty of dissecting the superior pole of the thymus. We present a modified left-hand-dominant subxiphoid thoracoscopic thymectomy, summarizing our experience to modularize the surgical workflow and achieving true ambidextrous operation. This approach offers detailed technical guidance for left-handed early-career surgeons and provides a practical solution for right-handed surgeons to navigate challenges related to operative angles and instrument collisions.