Assessment of Performance Carryover Effects Due to Successive Exposure to Different Lateral Camera Rotations in a Laparoscopic Training Environment

Abstract

Objective The aim of this study was to assess performance carryover effects associated with different successive lateral camera rotations in the laparoscopic training environment. Background Laparoscopy requires surgeons to adapt to disruptions of visuomotor mapping. A gradual adaptation process is hypothesized to be effective up to a given rotation threshold; this threshold may have performance implications for successive exposure to different lateral camera rotations. Method Two experiments utilized a laparoscopic training task. Experiment 1 exposed novices to a subsequent rotation that was either 45° larger than one of the initial rotations of 45°, 75°, 105°, and 135° or 45° smaller than one of the initial rotations of 90°, 120°, 150°, and 180°. Experiment 2 exposed novices to either stepwise increasing rotations (0° to 180°) or stepwise decreasing rotations (180° to 0°). Results Regarding Experiment 1, performance generally improved for subsequent rotations that were 45° larger than the initial rotation, except for one condition (initial rotation, 105°; subsequent rotation, 150°). Performance generally improved for subsequent rotations that were 45° smaller than the initial rotation, except for one condition (initial rotation, 120°; subsequent rotation, 75°). Experiment 2 indicated worst performance at 120° for the increasing and decreasing conditions. This finding suggests an identical threshold for increasing and decreasing rotations, which is inconsistent with Experiment 1 results. Conclusion Improved performance due to carryover effects from successive exposure to lateral camera rotations in the laparoscopic training environment is contingent on the specific camera rotations. Application Supplementary laparoscopic training might be needed for surgeries that entail certain successive lateral camera rotations.

Blood Flow Velocity of the Middle Cerebral Arteries: A Real-Time Measure of Attentional Load in the Laparoscopic Surgery Environment?

“…These results are consistent with Cunningham (1989) and Klein et al (2015). While the star drops/star transfers ratio was not significantly different between the groups, this measure has shown to be problematic in prior research (see Neilson & Klein, 2018).…”

“…A laparoscopic trainer similar to that used by Neilson and Klein (2018) was used. The simulator had a 7.75" long opening with a 1" wide rigid cross strap containing two small entry port holes for the laparoscopic graspers (Ethicon 5.00 mm forceps graspers).…”

“…The pegboard was secured onto the simulator base, in the center horizontally (x axis), 5.75cm from each side's edge, and 8.5 cm in depth (y axis) from the front and back edge. Klein et al (2015) and Neilson and Klein (2018). Figure 1c is adapted from Neilson & Klein (2018).…”

“…BFV was measured using the Routine and Doppler-M-Mode QL software (Version 3.5.5, DWL). Neilson and Klein (2018).…”

“…Top-down interior view of simulator. Figures 1a and 1b are fromKlein et al (2015) andNeilson and Klein (2018). Figure1cis adapted fromNeilson & Klein (2018).…”