Laser visual guidance versus two-dimensional vision in laparoscopy: a randomized trial

Abstract

BackgroundDuring laparoscopy, the surgeon’s loss of depth perception and spatial orientation is problematic. Laser visual guidance (LVG) is an innovative technology that improves depth perception to enhance the visual field. In this trial, we examined the effect of LVG on surgical novices’ motor skills, quality of task performance, and cognitive workload.MethodsWe designed a randomized controlled trial following the CONSORT statement. Thirty-two surgical novices completed the Training and Assessment of Basic Laparoscopic Techniques (TABLT) test. The first attempt allowed participants to familiarize themselves with the exercises. We then randomized the participants, and they completed a test session using either LVG or conventional two-dimensional vision.ResultsWe found no significant difference between using the LVG tool and conventional 2D vision; however, both the mean completion time and movements used were less in the LVG group: Mean time used in the LVG group was 1288 s (95 % CI 1188–1388) versus 1354 s (95 % CI 1190–1518) (p = 0.45); mean angular path length used in the LVG group was 24,049° (95 % CI 20,761–27,336) versus 26,014° (95 % CI 22,059–29,970) (p = 0.42); mean path length in the LVG group was 4560 cm (95 % CI 3971–5,149 cm) versus 5062 cm (95 % CI 4328–5797), (p = 0.26). Moreover, the mean TABLT performance score was higher in the LVG group compared with the 2D group, although not significant: 379 (95 % CI 352–405) versus 338 (95 % CI 288–387) (p = 0.14). No significant difference was found between the groups’ cognitive workloads.ConclusionWe found no significant improvement of laparoscopic motor skills when using LVG, although a tendency toward improved performance was seen. LVG could have the potential to help novice surgeons acquire basic laparoscopic; however, further development of the concept and validation is needed to confirm this.

Systematic review of measurement tools to assess surgeons' intraoperative cognitive workload

“…In general, studies presenting a higher MERSQI score were those that used an RCT design. The main characteristics of all included studies, as well as the MERSQI score for each are shown in Table S2 (supporting information).…”

Multi-angle laser device improves novice learning of C-arm fluoroscopy for lumbar spine surgery

“…Incorporating technologies like the MLD into traditional C-arm education can assist novice operators in achieving efficient and accurate imaging [ 11 ]. The visual guidance provides real-time feedback to facilitate spatial conceptualization and minimize trial-and-error adjustments [ 12 , 13 ]. This enhances learning efficiency while reducing risks associated with excessive radiation and surgical complications [Wu, 2023 #3298].…”

“…This allows the laser projections to visualize the underlying X-ray trajectories on the body surface. By enabling users to align the laser with the target position on the screen, the MLD provides visual guidance for rapid and accurate positioning [ 12 , 13 ].…”

“…Both groups showed equally high interest, likely as a novel educational experience. While traditional training requires extensive hands-on practice [ 10 ], MLD accelerated learning by reducing technical barriers through real-time guidance [ 12 , 13 ].…”