Higher quality camera navigation improves the surgeon's performance: Evidence from a pre-clinical study

Huettl, Florentine; Huber, Tobias; Duwe, Matthias; Lang, Hauke; Paschold, M.; Kneist, W.

doi:10.4103/jmas.jmas_143_19

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…Laparoscopic colorectal surgery requires advanced skills of the whole surgical team. The influence of high-quality camera navigation as an aspect of effective and safe surgery has been shown [5,12,13]. The transfer of quality control and quality assessment from simulation-based training into the operation room, however, is not established yet.…”

Section: Discussionmentioning

confidence: 99%

Rating of camera navigation skills in colorectal surgery

Huettl

Lang

Paschold

et al. 2020

Int J Colorectal Dis

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Purpose In advanced minimally invasive surgery the laparoscopic camera navigation (LCN) quality can influence the flow of the operation. This study aimed to investigate the applicability of a scoring system for LCN (SALAS score) in colorectal surgery and whether an adequate scoring can be achieved using a specified sequence of the operation. Methods The score was assessed by four blinded raters using synchronized video and voice recordings of 20 randomly selected laparoscopic colorectal surgeries (group A: assessment of the entire operation; group B: assessment of the 2nd and 3rd quartile). Experience in LCN was defined as at least 100 assistances in complex laparoscopic procedures. Results The surgical teams consisted of three residents, three fellows, and two attendings forming 15 different teams. The ratio between experienced and inexperienced camera assistants was balanced (n = 11 vs. n = 9). Regarding the total SALAS score, the four raters discriminated between experienced and inexperienced camera assistants, regardless of their group assignment (group A, p < 0.05; group B, p < 0.05). The score's interrater variability and reliability were proven with an intraclass correlation coefficient of 0.88. No statistically relevant correlation was achieved between operation time and SALAS score. Conclusion This study presents the first intraoperative, objective, and structured assessment of LCN in colorectal surgery. We could demonstrate that the SALAS score is a reliable tool for the assessment of LCN even when only the middle part (50%) of the procedure is analyzed. Construct validity was proven by discriminating between experienced and inexperienced camera assistants.

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Section: Discussionmentioning

confidence: 99%

Rating of camera navigation skills in colorectal surgery

Huettl

Lang

Paschold

et al. 2020

Int J Colorectal Dis

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“…Robotic surgery returns the control of the camera to the operating surgeon on a stable platform, resulting in a steadier view of the operative field with better centering, horizon adjustment, zoom control, and instrument visualisation. In a simulation study of 84 medical students, surgeon performance was significantly influenced by the quality of the laparoscopic camera navigator [ 12 ]. The use of robotic laparoscopic holder has been shown to provide consistent control of the view of the operative field [ 13 ].…”

Section: Surgeon Camera Controlmentioning

confidence: 99%

Visualisation ergonomics and robotic surgery

Wong

Crowe

2023

J Robotic Surg

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Stereopsis may be an advantage of robotic surgery. Perceived robotic ergonomic advantages in visualisation include better exposure, three-dimensional vision, surgeon camera control, and line of sight screen location. Other ergonomic factors relating to visualisation include stereo-acuity, vergence–accommodation mismatch, visual–perception mismatch, visual–vestibular mismatch, visuospatial ability, visual fatigue, and visual feedback to compensate for lack of haptic feedback. Visual fatigue symptoms may be related to dry eye or accommodative/binocular vision stress. Digital eye strain can be measured by questionnaires and objective tests. Management options include treatment of dry eye, correction of refractive error, and management of accommodation and vergence anomalies. Experienced robotic surgeons can use visual cues like tissue deformation and surgical tool information as surrogates for haptic feedback.

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Optimizing laparoscopic training efficacy by ‘deconstruction into key steps’: a randomized controlled trial with novice medical students

et al. 2022

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Background Simulator training is an effective way of acquiring laparoscopic skills but there remains a need to optimize teaching methods to accelerate learning. We evaluated the effect of the mental exercise ‘deconstruction into key steps’ (DIKS) on the time required to acquire laparoscopic skills. Methods A randomized controlled trial with undergraduate medical students was implemented into a structured curricular laparoscopic training course. The intervention group (IG) was trained using the DIKS approach, while the control group (CG) underwent the standard course. Laparoscopic performance of all participants was video-recorded at baseline (t0), after the first session (t1) and after the second session (t2) nine days later. Two double-blinded raters assessed the videos. The Impact of potential covariates on performance (gender, age, prior laparoscopic experience, self-assessed motivation and self-assessed dexterity) was evaluated with a self-report questionnaire. Results Both the IG (n = 58) and the CG (n = 68) improved their performance after each training session (p < 0.001) but with notable differences between sessions. Whereas the CG significantly improved their performance from t0 –t1 (p < 0.05), DIKS shortened practical exercise time by 58% so that the IG outperformed the CG from t1 -t2, (p < 0.05). High self-assessed motivation and dexterity associated with significantly better performance (p < 0.05). Male participants demonstrated significantly higher overall performance (p < 0.05). Conclusion Mental exercises like DIKS can improve laparoscopic performance and shorten practice times. Given the limited exposure of surgical residents to simulator training, implementation of mental exercises like DIKS is highly recommended. Gender, self-assessed dexterity, and motivation all appreciably influence performance in laparoscopic training.

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Higher quality camera navigation improves the surgeon's performance: Evidence from a pre-clinical study

Cited by 5 publications

References 13 publications

Rating of camera navigation skills in colorectal surgery

Rating of camera navigation skills in colorectal surgery

Visualisation ergonomics and robotic surgery

Optimizing laparoscopic training efficacy by ‘deconstruction into key steps’: a randomized controlled trial with novice medical students

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