Three-dimensional visualisation and articulating instrumentation: Impact on simulated laparoscopic tasks.

Hdl Handle:
http://hdl.handle.net/10675.2/117
Title:
Three-dimensional visualisation and articulating instrumentation: Impact on simulated laparoscopic tasks.
Authors:
Bittner, James G.; Hathaway, Christopher A; Brown, James A.
Abstract:
Laparoscopy requires the development of technical skills distinct from those used in open procedures. Several factors extending the learning curve of laparoscopy include ergonomic and technical difficulties, such as the fulcrum effect and limited degrees of freedom. This study aimed to establish the impact of four variables on performance of two simulated laparoscopic tasks. METHODS: Six subjects including novice (n=2), intermediate (n=2) and expert surgeons completed two tasks: 1) four running sutures, 2) simple suture followed by surgeon's knot plus four square knots. Task variables were suturing angle (left/right), needle holder type (standard/articulating) and visualisation (2D/3D). Each task with a given set of variables was completed twice in random order. The endpoints included suturing task completion time, average and maximum distance from marks and knot tying task completion time. RESULTS: Suturing task completion time was prolonged by 45-degree right angle suturing, articulating needle holder use and lower skill levels (all P < 0.0001). Accuracy also decreased with articulating needle holder use (both P < 0.0001). 3D vision affected only maximum distance (P=0.0108). For the knot tying task, completion time was greater with 45-degree right angle suturing (P=0.0015), articulating needle holder use (P < 0.0001), 3D vision (P=0.0014) and novice skill level (P=0.0003). Participants felt that 3D visualisation offered subjective advantages during training. CONCLUSIONS: Results suggest construct validity. A 3D personal head display and articulating needle holder do not immediately improve task completion times or accuracy and may increase the training burden of laparoscopic suturing and knot tying.
Citation:
J Minim Access Surg. 2008 Apr-Jun; 4(2):31-38
Issue Date:
26-Jun-2009
URI:
http://hdl.handle.net/10675.2/117
PubMed ID:
19547678
PubMed Central ID:
PMC2699064
Type:
Journal Article
ISSN:
1998-3921
Appears in Collections:
Department of Surgery: Faculty Research and Presentations

Full metadata record

DC FieldValue Language
dc.contributor.authorBittner, James G.en_US
dc.contributor.authorHathaway, Christopher Aen_US
dc.contributor.authorBrown, James A.en_US
dc.date.accessioned2010-09-24T22:03:23Z-
dc.date.available2010-09-24T22:03:23Z-
dc.date.issued2009-6-26en_US
dc.identifier.citationJ Minim Access Surg. 2008 Apr-Jun; 4(2):31-38en_US
dc.identifier.issn1998-3921en_US
dc.identifier.pmid19547678en_US
dc.identifier.urihttp://hdl.handle.net/10675.2/117-
dc.description.abstractLaparoscopy requires the development of technical skills distinct from those used in open procedures. Several factors extending the learning curve of laparoscopy include ergonomic and technical difficulties, such as the fulcrum effect and limited degrees of freedom. This study aimed to establish the impact of four variables on performance of two simulated laparoscopic tasks. METHODS: Six subjects including novice (n=2), intermediate (n=2) and expert surgeons completed two tasks: 1) four running sutures, 2) simple suture followed by surgeon's knot plus four square knots. Task variables were suturing angle (left/right), needle holder type (standard/articulating) and visualisation (2D/3D). Each task with a given set of variables was completed twice in random order. The endpoints included suturing task completion time, average and maximum distance from marks and knot tying task completion time. RESULTS: Suturing task completion time was prolonged by 45-degree right angle suturing, articulating needle holder use and lower skill levels (all P < 0.0001). Accuracy also decreased with articulating needle holder use (both P < 0.0001). 3D vision affected only maximum distance (P=0.0108). For the knot tying task, completion time was greater with 45-degree right angle suturing (P=0.0015), articulating needle holder use (P < 0.0001), 3D vision (P=0.0014) and novice skill level (P=0.0003). Participants felt that 3D visualisation offered subjective advantages during training. CONCLUSIONS: Results suggest construct validity. A 3D personal head display and articulating needle holder do not immediately improve task completion times or accuracy and may increase the training burden of laparoscopic suturing and knot tying.en_US
dc.rightsThe PMC Open Access Subset is a relatively small part of the total collection of articles in PMC. Articles in the PMC Open Access Subset are still protected by copyright, but are made available under a Creative Commons or similar license that generally allows more liberal redistribution and reuse than a traditional copyrighted work. Please refer to the license statement in each article for specific terms of use. The license terms are not identical for all articles in this subset.en_US
dc.titleThree-dimensional visualisation and articulating instrumentation: Impact on simulated laparoscopic tasks.en_US
dc.typeJournal Articleen_US
dc.identifier.pmcidPMC2699064en_US
dc.contributor.corporatenameVirtual Education and Surgical Simulation Laboratory (VESSL), Section of Urology, Department of Surgery, Medical College of Georgiaen_US
dc.contributor.corporatenameDepartment of Surgeryen_US
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