Sideways Camera Rotations of 90° and 135° Result in Poorer Performance of Laparoscopic Tasks for Novices

Abstract

The results indicate that 90° and 135° sideways laparoscope placements may result in worse performance for novices in the laparoscopic environment, indicating potentially longer learning curves for these conditions in the laparoscopic as well as other teleoperation environments.

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

“…Research by Klein et al (2015) and Ames et al (2006) has been inconsistent with regard to the performance impact of lateral rotations in the laparoscopic training environment, which might be due to performance carryover effects that may have occurred in Ames et al Thus, the specific goals and predictions of the present study are as follows:…”

“…The aforementioned performance findings by Klein et al (2015) can been explained by two mechanisms: (a) a gradual adaptation process (Bock, Abeele, & Eversheim, 2003;Cunningham, 1989) and (b) a movement (Cunningham, 1989) or axis (Bock et al, 2003) inversion (both terms have been used to indicate the same concept, but we will be using the term movement inversion for the remainder of this paper). Specifically, the gradual adaptation process suggests performance gets poorer as one gradually rotates forward from an internal reference frame up to a given threshold (see Figure 2A).…”

“…Given that the discrepancy between Klein et al (2015) and Ames et al (2006) might be due to carryover effects, it is important to (a) determine whether Klein et al's findings replicate in the laparoscopic training environment and (b) assess performance carryover effects caused by exposure to different successive, lateral rotations in the laparoscopic training environment. This latter inquiry is of particular interest, as laparoscopic surgeons sometimes have to move the camera to a different incision site during a procedure to get a better view of the target tissue, resulting in exposure to a different degree of lateral camera rotation.…”

“…Prior research by Klein et al (2015) on lateral camera rotations in the laparoscopic training environment indicated that novices' performance on a straight-line pointing task and a pegtransfer task was superior at the 0° rotation and that novice participants' performance progressively declined as the lateral camera rotations reached rotations between 90° and 135°. In contrast, the 180° camera rotation resulted in superior performance compared with performance observed at lateral rotations between 90° and 135°.…”

“…Lengthy learning curves may be due, in part, to the inherent disruptions of the visuomotor mapping in laparoscopy caused by having to view the target tissue indirectly on a monitor via the camera. Laparoscopic simulator research has shown that the optimal camera position is directly in front of participants (at the 0° rotation; Haveran et al, 2007;Klein, Wheeler, & Craig, 2015). This position produces congruence between the visually displayed instrument movements and the actual instrument movements in the operative site, minimizing the disruption of visuomotor mapping.…”