Crothers I R, Gallagher A G, McClure N, James D T, McGuigan J
School of Psychology, The Queen's University of Belfast, UK.
Endoscopy. 1999 Jun;31(5):365-9. doi: 10.1055/s-1999-26.
The inversion of the normal laparoscopic image around the Y-axis has been shown to facilitate the rate of learning of a laparoscopic task in novice subjects. The aim of this study was to investigate the effect of Y-axis image inversion on the performance of experienced laparoscopic surgeons; this had not been previously investigated.
A total of 16 experienced surgeons,who had already carried out more than 50 operative laparoscopic procedures, and 16 novice participants, who had carried out no procedures, were required to make multiple defined incisions under laparoscopic laboratory conditions within ten 1-minute periods. Participants were randomly allocated to perform the task under either normal or Y-axis inverted imaging conditions (eight experienced surgeons and eight novices in each condition).
Y-axis inversion had a significant detrimental effect on the performance of the surgeons, whilst facilitating the performance of novices. The surgeons however, adapted to the inverted condition rapidly, showing a significant improvement in performance over the ten trials.
The Y-axis-inverted image has a detrimental effect on the performance of experienced surgeons, indicating that they have automated to the "fulcrum effect" of the abdominal wall on instrument manipulation. Y-axis-image inversion was found to facilitate significant learning trends, regardless of the participants' level of experience.
正常腹腔镜图像绕Y轴翻转已被证明可提高新手完成腹腔镜任务的学习速度。本研究旨在调查Y轴图像翻转对经验丰富的腹腔镜外科医生操作的影响；此前尚未对此进行过研究。
共有16名经验丰富的外科医生（他们已经进行了超过50例腹腔镜手术）和16名新手参与者（他们未进行过任何手术）被要求在腹腔镜实验室条件下，在十个1分钟时间段内进行多次规定的切口操作。参与者被随机分配在正常成像或Y轴翻转成像条件下执行任务（每种条件下有8名经验丰富的外科医生和8名新手）。
Y轴翻转对外科医生的操作有显著的不利影响，而对新手的操作有促进作用。然而，外科医生能迅速适应翻转条件，在十次试验中操作表现有显著改善。
Y轴翻转图像对经验丰富的外科医生的操作有不利影响，表明他们已经适应了腹壁对器械操作的“支点效应”。无论参与者的经验水平如何，Y轴图像翻转都能促进显著的学习趋势。
