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Today, we're going to review how to hold and use some of the most common surgical instruments with your left hand. Now, a small disclaimer while there are left handed surgical instruments out there, oftentimes these are not available to students. So I'll be demonstrating how to use right hand surgical instruments. But in your left hand, I myself am a left handed surgeon and will often switch back and forth between holding instruments in my right and left hand depending on what feels most comfortable or what's easier. The first instrument we're going to start with is the four step. The best way to use this is to hold it like a pencil in your hand. You generally don't want to be too close or too far away from the tip of the instrument. Somewhere in the middle is best. Many of us will want to apply a lot of pressure when using this instrument to pick up tissue, but that generally isn't needed and may even cause your forcep tips to cross gentle to moderate pressure is all that is needed. Next, we'll move on to your needle driver, you may see you're attending or residents hold this instrument a variety of ways. But generally the best way to hold this instrument when you're first starting is to place your ring finger and thumb into the finger, holds, place your middle finger on the outside of the finger, hold where your ring finger is and place your index finger along the length of the instrument. For stability locking instruments can be a bit more challenging with your left hand as the locking mechanism is designed to be pushed out with your right hand. But in this case, what we'll need to do is pull it in with our left hand. What I mean by that is you'll want to pull in with your thumb to unlock the instrument. This can be very challenging as there's often not much space to do that. So another way to think about it is pushing out with your right finger, right handed, scissors can be used in your left hand, but we'll just need to be held in a different way. You'll generally need to hold the scissors at an angle in order to allow them to cut. Once you've gotten the hang of this, there's a good way to use them when it comes to cutting suture. When you're unsure how long to leave the length of the future, you can always ask. But generally, you can use the opened edge of the scissor to slide down the suture until you hit the. Not once you feel that not turn the scissors 45 degrees before cutting, which would leave you with about a 1 to 2 millimeter tail each time. The last instrument I'll encourage you to use are the people in patient around you while every surgeon likes to think they have steady unwavering hands. The truth of the matter is a lot of us have a small shake or tremor. Use what's around you to help stabilize your hands or even use two hands when you're able to, to create greater stability while executing these skills in the operating room.