National Surgical Training Centre, Royal College of Surgeons in Ireland, 123, St. Stephens Green, Dublin 2, Ireland.
Surg Endosc. 2009 Dec;23(12):2684-91. doi: 10.1007/s00464-008-0261-x.
Minimal access surgery is associated with increased risk of complications, particularly early in a surgeon's laparoscopic career. This is mostly due to loss of depth cues, degraded tactile feedback from surgical instrument, and the "fulcrum effect". Degraded and restricted image on the monitor makes camera orientation very important. The objective of this study is to investigate the effects of camera rotation on laparoscopic performance.
In two separate studies 100 laparoscopic novices and 7 experienced laparoscopic surgeons ([300 laparoscopic procedures) were asked to perform a simple laparoscopic cutting task and tie intracorporeal square-knots (respectively) under 0, 15, 45, 90, and 180 camera rotation.
In study 1 camera rotation significantly degraded performance of laparoscopic novices (p\0.00001) and also increased their error rate (p\0.00001). In study 2 camera rotation significantly increased the length of time it took surgeons to tie an intracorporeal square-knot (p\0.00001) and the number of errors made (p\0.0001).
Unintentional camera rotation during surgery should be avoided to eliminate one potential source for errors.
微创手术相关的并发症风险增加，尤其是在外科医生腹腔镜职业生涯的早期。这主要是由于深度线索的丧失，手术器械的触觉反馈降低，以及“支点效应”。监视器上质量较差且受到限制的图像使得摄像角度的选择非常重要。本研究旨在探讨摄像角度旋转对腹腔镜操作的影响。
在两项独立的研究中，100 名腹腔镜新手和 7 名有经验的腹腔镜外科医生（[300 例腹腔镜手术）被要求在 0、15、45、90 和 180 度摄像角度旋转下完成简单的腹腔镜切割任务和体内方结打结任务（分别）。
在研究 1 中，摄像角度旋转显著降低了腹腔镜新手的操作表现（p\0.00001），并增加了他们的错误率（p\0.00001）。在研究 2 中，摄像角度旋转显著增加了外科医生完成体内方结打结所需的时间（p\0.00001）和错误数量（p\0.0001）。
手术过程中应避免无意的摄像角度旋转，以消除一个潜在的错误来源。
