Wentink M, Breedveld P, Stassen L P S, Oei I H, Wieringa P A
Man-Machine Systems Section, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands.
Surg Endosc. 2002 Nov;16(11):1533-7. doi: 10.1007/s00464-001-9214-3. Epub 2002 Jun 20.
Passing an instrument through a small incision alters the kinematics of the instrument, thus hampering hand-eye coordination. Nevertheless, the incision provides a stable, nearly invariant, point of rotation for instrument movements. Therefore, we set out to evaluate the effects of the altered kinematics on hand-eye coordination. In addition, we assessed the hypothesis that the hand-eye coordination of laparoscopic surgeons incorporates the incision as a point of reference.
Eight surgeons with experience in laparoscopy repeatedly performed a positioning task on a two-dimensional endoscopic manipulation simulator. Task time was measured. In the first experiment, normal endoscopic manipulation was compared to a condition in which the kinematic effects of the incision were compensated for. In the second experiment, the instrument shaft on the monitor was not visible during half of the trials, so that all visual information about the location of the incision was obscured.
Task performance improved significantly when the kinematic effects of the incision were compensated for (p = 0.001). Task performance improved when the instrument shaft was clearly visible on the monitor (p <0.05).
Compensating for the kinematic effects introduced by the incision improves hand-eye coordination. The results of this study indicate that the incision provides a point of reference for hand-eye coordination during endoscopic manipulation.
通过小切口插入器械会改变器械的运动学，从而妨碍手眼协调。然而，切口为器械运动提供了一个稳定、几乎不变的旋转点。因此，我们着手评估运动学改变对手眼协调的影响。此外，我们评估了腹腔镜外科医生的手眼协调将切口作为参考点的假设。
八位有腹腔镜手术经验的外科医生在二维内镜操作模拟器上反复执行定位任务。测量任务时间。在第一个实验中，将正常内镜操作与补偿切口运动学效应的情况进行比较。在第二个实验中，在一半的试验中，监视器上的器械杆不可见，从而使关于切口位置的所有视觉信息都被遮挡。
当切口的运动学效应得到补偿时，任务表现显著改善（p = 0.001）。当器械杆在监视器上清晰可见时，任务表现得到改善（p <0.05）。
补偿切口引入的运动学效应可改善手眼协调。本研究结果表明，切口为内镜操作期间的手眼协调提供了一个参考点。
