Assessing the benefits of ?gaze-down? display location in complex tasks

Omar, A. M.; Wade, Nicholas; Brown, Stuart I.; Cuschieri, Alfred

doi:10.1007/s00464-004-8141-5

Cited by 33 publications

(17 citation statements)

References 9 publications

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“…In addition, ''Smartimage'' and heads-up display technology would allow for apposition of radiographic and clinical data to the laparoscopic view, reducing the need to divert one's gaze for the purpose of reviewing images or troubleshooting equipment. Cuschieri and coworkers [14,15] have performed extensive studies into the benefits, including resultant improvements in workflow, of a gazedown visual display in relation to the physical and cognitive workload required of surgeons. Innovations of technological, display, and imaging systems could result from further study of surgeon-specific gaze disruptions and the optimum workflow needed in the surgical environment.…”

Section: Discussionmentioning

confidence: 99%

Gaze disruptions experienced by the laparoscopic operating surgeon

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Gaze disruptions experienced by the laparoscopic operating surgeon

et al. 2009

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“…In this monitor configuration, the working posture is the most neutral. Studies examining efficiency of movement and task performance during MIS advise a monitor configuration straight in front of the surgeon and in the direct vicinity of the operating field [10,15,21,22]. This monitor configuration brings the viewing direction back to the direction of work and restores the natural eye-hand-target axis.…”

Section: Discussionmentioning

confidence: 99%

Ergonomic assessment of neck posture in the minimally invasive surgery suite during laparoscopic cholecystectomy

et al. 2008

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Background With the expanding implementation of minimally invasive surgery, the operating team is confronted with challenges in the field of ergonomics. Visual feedback is derived from a monitor placed outside the operating field. This crossover trial was conducted to evaluate and compare neck posture in relation to monitor position in a dedicated minimally invasive surgery (MIS) suite and a conventional operating room. Methods Assessment of the neck was conducted for 16 surgeons, assisting surgeons, and scrub nurses performing a laparoscopic cholecystectomy in both types of operating room. Flexion and rotation of the cervical spine were measured intraoperatively using a video analysis system. A two-question visual analog scale (VAS) questionnaire was used to evaluate posture in relation to the monitor position. Results Neck rotation was significantly reduced in the MIS suite for the surgeon (p = 0.018) and the assisting surgeon (p \ 0.001). Neck flexion was significantly improved in the MIS suite for the surgeon (p \ 0.001) and the scrub nurse (p = 0.018). On the questionnaire, the operating room team scored their posture significantly higher in the MIS suite and also indicated fewer musculoskeletal complaints.Conclusions The ergonomic quality of the neck posture is significantly improved in the MIS suite for the entire operating room team.Keywords Ergonomics Á Laparoscopic cholecystectomy Á Minimally invasive surgery Á Neck Á Operating room Á Posture Minimally invasive surgery (MIS) plays a major part in modern abdominal surgery, urology, and gynecology and has become the treatment of choice for a still growing number of procedures. Most of the advantages with MIS are patient related. Less blood loss, less postoperative pain, shorter hospital admissions, quicker reintroduction into society, and a superior cosmetic result are some wellestablished MIS advantages [1][2][3][4].On the other hand, MIS confronts the surgeon and his or her team with some challenging aspects, primarily in the area of ergonomics and efficiency [5,6]. The necessity of additional equipment-including electrocautery and insufflation devices, monitors, video equipment, wiring, and tubing, usually stored outside the operating room on large heavy trolleys-has compromised operating room efficiency and prolonged turnover times [7].During the procedure, the surgeon must work with long instruments that move invertedly inside the abdomen and with a certain scaling effect, also known as the fulcrum effect [8]. The entire operating team derives the visual feedback of their actions from a monitor positioned on top of a laparoscopic trolley that stands outside the operative field and away from the patient. Due to this positioning, the

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“…Perceptual confusion may subsequently affect laparoscopic task efficiency. Several studies suggest that altered monitor and camera location in relation to the position of the surgeon may lead to sensory-motor disorientation with deleterious effects on laparoscopic task performance [1][2][3][4][5][6][7][8][9][10]. The degree to which camera and monitor location may influence the performance of laparoscopic tasks, however, is not well established.…”

Section: Introductionmentioning

confidence: 99%

Optimizing laparoscopic task efficiency: the role of camera and monitor positions

et al. 2007

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Experienced subjects demonstrated superior performance under all study conditions. Optimally, the camera should be directly in front and the monitor should be directly across from a surgeon. Alternatively, the monitor/camera could be placed opposite to the surgeon's non-dominant hand. The suboptimal camera/monitor conditions are especially difficult to overcome for inexperienced subjects. Monitor and camera positioning must be emphasized to ensure optimal laparoscopic performance.

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Assessing the benefits of ?gaze-down? display location in complex tasks

Abstract: The gaze-down stance reduces task time and errors, as compared with a gaze-up stance. The reduction in time and errors is more appreciable as task complexity increases.

Cited by 33 publications

References 9 publications

Gaze disruptions experienced by the laparoscopic operating surgeon

Gaze disruptions experienced by the laparoscopic operating surgeon

Ergonomic assessment of neck posture in the minimally invasive surgery suite during laparoscopic cholecystectomy

Optimizing laparoscopic task efficiency: the role of camera and monitor positions

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