Pedowitz Robert, Nicandri Gregg, Tuchschmid Stefan
University of California.
University of Rochester School of Medicine and Dentistry, Rochester, New York.
Stud Health Technol Inform. 2016;220:289-94.
Safe and effective arthroscopic surgery requires ambidextrous motor skills. The current study examined dominant versus non-dominant hand performance on a virtual reality serious game in a group of expert arthroscopic surgeons (n=15) compared to a group of orthopedic surgery residents (n=10). A virtual reality Tetris game was performed with the arthroscopic camera and arthroscope in one hand, using an arthroscopic grasping tool in the opposite hand to manipulate the virtual Tetris blocks onto the game grid. A second run was performed after swapping instruments between hands. The order of hand testing was randomized. There was no statistically significant difference in exercise time, grasper path length, or camera path length between the right and left hands of the expert surgeons. In contrast, there were statistically significant differences in all of these parameters between the two hands for the orthopedic surgery residents, with better performance when the grasping tool was used in the dominant hand. The findings of this study suggest that virtual reality games which incorporate progressive cognitive loading could be used to facilitate training, automation, and objective assessment of surgical motor skills.
安全有效的关节镜手术需要具备双手灵活操作的运动技能。本研究对比了一组专家级关节镜外科医生（n = 15）和一组骨科住院医师（n = 10）在虚拟现实严肃游戏中优势手与非优势手的操作表现。使用关节镜摄像头和关节镜，一手操作，另一手使用关节镜抓持工具将虚拟俄罗斯方块方块放置到游戏网格上，进行虚拟现实俄罗斯方块游戏。双手交换器械后再进行第二轮游戏。手部测试顺序随机。专家外科医生的右手和左手在运动时间、抓持工具路径长度或摄像头路径长度方面无统计学显著差异。相比之下，骨科住院医师双手在所有这些参数上均存在统计学显著差异，使用优势手操作抓持工具时表现更佳。本研究结果表明，包含渐进性认知负荷的虚拟现实游戏可用于促进手术运动技能的训练、自动化和客观评估。
