Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
Department for Visceral, Thoracic and Vascular Surgery at the University Hospital, Technical University Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Surg Endosc. 2018 Mar;32(3):1174-1183. doi: 10.1007/s00464-017-5789-1. Epub 2017 Aug 24.
Technical limitations of minimally invasive surgery challenge both surgeons and camera assistants. Current research indicates that visual-spatial ability (VSA) has impact on learning of laparoscopic camera navigation (LCN). However, it remains unclear if complexity of LCN tasks influences the impact of VSA. The aim of this study was to examine the influence of VSA on LCN training within tasks of different complexity levels.
The present study was conducted as a monocentric prospective trial. VSA was assessed with a cube comparison test before participants underwent LCN training. LCN training consisted of three tasks with increasing complexity. Each task was performed four times and performance was assessed each time. Correlations and multivariate regression analysis were used to assess the influence of VSA on LCN skills.
Seventy-one participants were included (35 males). Significant performance improvement and faster completion times were observed from the first to fourth trial of all three LCN training tasks. Significant positive correlations between VSA and performance on LCN task 3 were found (performance: r = 0.47; p < 0.001, time: r = -0.43; p < 0.001). Multivariate regression revealed that higher VSA resulted in greater reduction of time between the first trials of LCN training task 3 (B = -1.67, p = 0.031).
In the present study, all trainees improved LCN performance during the training. VSA seems to have impact on LCN performance and training progress particularly for complex LCN tasks. The relation of VSA and LCN performance was stronger for less experienced participants and in the beginning of the learning phase.
微创手术的技术限制对外科医生和摄像助手都构成了挑战。目前的研究表明，空间视觉能力（VSA）对腹腔镜摄像导航（LCN）的学习有影响。然而，LCN 任务的复杂性是否会影响 VSA 的影响仍不清楚。本研究旨在检查 VSA 对不同复杂程度任务中 LCN 训练的影响。
本研究为单中心前瞻性试验。在参与者接受 LCN 训练之前，使用立方比较测试评估 VSA。LCN 训练包括三个具有不同复杂性的任务。每个任务执行四次，每次评估性能。使用相关性和多元回归分析评估 VSA 对 LCN 技能的影响。
71 名参与者被纳入（35 名男性）。在所有三个 LCN 训练任务的前四次试验中，观察到显著的性能提高和更快的完成时间。在 LCN 任务 3 的表现与 VSA 之间发现了显著的正相关（表现：r=0.47;p<0.001，时间：r=0.43;p<0.001）。多元回归显示，较高的 VSA 导致 LCN 训练任务 3 的前几次试验之间的时间减少（B=-1.67，p=0.031）。
在本研究中，所有受训者在培训过程中都提高了 LCN 的表现。VSA 似乎对 LCN 表现和培训进展有影响，特别是对于复杂的 LCN 任务。VSA 与 LCN 性能之间的关系在经验较少的参与者和学习阶段开始时更为强烈。
