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

Abstract

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.

Does monitor position influence visual-motor performance during minimally invasive surgery?

“…However, consistent with previous studies that have found optimal performance with the monitor at 0 and significant degradation in performance beyond 45 , 3,12,20 we observed a significant decrease in performance as indexed by MT in the initial trial in the 90 condition. PL (an index of accuracy) and NJ (a marker of fluency/smoothness) demonstrated similar trends but did not reach statistical significance thresholds.…”

“…The extant literature has demonstrated (i) performance advantage when the head and hands are pointed in the same direction during visual-motor tasks; (ii) a subjective preference of surgeons for the visual angle to be at 0 ; and (iii) an improved ability in experienced surgeons to deal with rotations of the visual display compared with less experienced surgeons. 11,12 These studies have not quantified the effects of head rotation/viewing angle on visual-motor control processed in MIS and thus the extent to which visual transformations modulate motoric control processes is unclear. Therefore, an empirical investigation into the role of monitor angle on motoric performance in MIS is necessary.…”

“…8 Several studies in the surgical literature have suggested that incomplete decoupling of head position signals during surgical tasks results in significant performance costs in MIS. [9][10][11][12][13] Generally, studies imply that MIS monitors should be positioned in front of the surgeon, and at eye level, in order to minimize inconsistency between the hand and eye. 9,13 Positioning the monitor head-on to the surgeon performing the procedure is also more likely to yield optimal performance 12 and, as a small-scale study suggests, is also a surgeon's preferred setup.…”

Learning curve of assistants in laparoscopic colorectal surgery: overcoming mirror imaging

“…Under such conditions, the mirror image of the operative field can disorient the assistant, potentially degrading the performance of their task. Several studies have measured surgical performance under mirror-image conditions in the experimental setting [6][7][8]; however, there are few reports on the extent of difficulties and progressive improvement in performance under reverse alignment conditions in the clinical setting. The present study attempted to examine the learning curve of the assistant during laparoscopic colorectal surgery from the viewpoint of overcoming problems associated with the mirror-imaging effect.…”

Compliance display using a tilting-plate tactile feedback device

“…In these circumstances, surgeons rely mostly on visual information during the operation. The provided visual information is usually limited [9] and more importantly cannot properly substitute for information regarding compliance, which is best perceived through the sense of touch [10]. For this reason, surgical instruments capable of sensing the mechanical properties of tissue and rendering missing tactile information to the surgeons are needed [6].…”