Partridge Roland W, Brown Fraser S, Brennan Paul M, Hennessey Iain A M, Hughes Mark A
Royal Hospital for Sick Children, Edinburgh, UK
University of Edinburgh Medical School, Edinburgh, UK.
Surg Innov. 2016 Feb;23(1):70-7. doi: 10.1177/1553350615594734. Epub 2015 Jul 14.
To assess the potential of the LEAP™ infrared motion tracking device to map laparoscopic instrument movement in a simulated environment. Simulator training is optimized when augmented by objective performance feedback. We explore the potential LEAP has to provide this in a way compatible with affordable take-home simulators.
LEAP and the previously validated InsTrac visual tracking tool mapped expert and novice performances of a standardized simulated laparoscopic task. Ability to distinguish between the 2 groups (construct validity) and correlation between techniques (concurrent validity) were the primary outcome measures.
Forty-three expert and 38 novice performances demonstrated significant differences in LEAP-derived metrics for instrument path distance (P < .001), speed (P = .002), acceleration (P < .001), motion smoothness (P < .001), and distance between the instruments (P = .019). Only instrument path distance demonstrated a correlation between LEAP and InsTrac tracking methods (novices: r = .663, P < .001; experts: r = .536, P < .001). Consistency of LEAP tracking was poor (average % time hands not tracked: 31.9%).
The LEAP motion device is able to track the movement of hands using instruments in a laparoscopic box simulator. Construct validity is demonstrated by its ability to distinguish novice from expert performances. Only time and instrument path distance demonstrated concurrent validity with an existing tracking method however. A number of limitations to the tracking method used by LEAP have been identified. These need to be addressed before it can be considered an alternative to visual tracking for the delivery of objective performance metrics in take-home laparoscopic simulators.
评估LEAP™红外运动跟踪设备在模拟环境中绘制腹腔镜器械运动轨迹的潜力。当通过客观性能反馈进行增强时，模拟器训练可得到优化。我们探讨LEAP以与经济实惠的家用模拟器兼容的方式提供这种反馈的潜力。
LEAP和先前经过验证的InsTrac视觉跟踪工具绘制了标准化模拟腹腔镜任务的专家和新手表现。区分两组的能力（结构效度）以及技术之间的相关性（同时效度）是主要的结果指标。
43名专家和38名新手的表现显示，LEAP得出的器械路径距离（P <.001）、速度（P =.002）、加速度（P <.001）、运动平滑度（P <.001）以及器械之间的距离（P =.019）等指标存在显著差异。只有器械路径距离显示出LEAP和InsTrac跟踪方法之间的相关性（新手：r =.663，P <.001；专家：r =.536，P <.001）。LEAP跟踪的一致性较差（平均未跟踪手部的时间百分比：31.9%）。
LEAP运动设备能够在腹腔镜箱式模拟器中使用器械跟踪手部运动。其区分新手和专家表现的能力证明了结构效度。然而，只有时间和器械路径距离与现有的跟踪方法显示出同时效度。已确定LEAP所使用的跟踪方法存在一些局限性。在将其视为家用腹腔镜模拟器中提供客观性能指标的视觉跟踪替代方法之前，需要解决这些问题。
