Department of Information Systems, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD, 21250, USA.
Department of Surgery, Anne Arundel Medical Center, 2001 Medical Pkwy, Annapolis, MD, 21401, USA.
Int J Comput Assist Radiol Surg. 2018 Sep;13(9):1463-1472. doi: 10.1007/s11548-018-1792-9. Epub 2018 May 23.
To assess a virtual pointer in supporting surgical trainees' development of professional vision in laparoscopic surgery.
We developed a virtual pointing and telestration system utilizing the Microsoft Kinect movement sensor as an overlay for any imagine system. Training with the application was compared to a standard condition, i.e., verbal instruction with un-mediated gestures, in a laparoscopic training environment. Seven trainees performed four simulated laparoscopic tasks guided by an experienced surgeon as the trainer. Trainee performance was subjectively assessed by the trainee and trainer, and objectively measured by number of errors, time to task completion, and economy of movement.
No significant differences in errors and time to task completion were obtained between virtual pointer and standard conditions. Economy of movement in the non-dominant hand was significantly improved when using virtual pointer ([Formula: see text]). The trainers perceived a significant improvement in trainee performance in virtual pointer condition ([Formula: see text]), while the trainees perceived no difference. The trainers' perception of economy of movement was similar between the two conditions in the initial three runs and became significantly improved in virtual pointer condition in the fourth run ([Formula: see text]).
Results show that the virtual pointer system improves the trainer's perception of trainee's performance and this is reflected in the objective performance measures in the third and fourth training runs. The benefit of a virtual pointing and telestration system may be perceived by the trainers early on in training, but this is not evident in objective trainee performance until further mastery has been attained. In addition, the performance improvement of economy of motion specifically shows that the virtual pointer improves the adoption of professional vision- improved ability to see and use laparoscopic video results in more direct instrument movement.
评估虚拟指针在支持腹腔镜手术外科实习生专业视觉发展方面的作用。
我们开发了一种虚拟指向和远程绘图系统，该系统利用 Microsoft Kinect 运动传感器作为任何成像系统的覆盖层。在腹腔镜培训环境中，应用程序培训与标准条件（即未经介导的手势进行口头指导）进行了比较。七名实习生在一名经验丰富的外科医生作为培训师的指导下完成了四个模拟腹腔镜任务。实习生和培训师对实习生的表现进行了主观评估，通过错误数量、完成任务的时间和运动的经济性来进行客观测量。
在错误和完成任务的时间方面，虚拟指针和标准条件之间没有显著差异。使用虚拟指针时，非主导手的运动经济性得到了显著改善（[公式：见文本]）。培训师认为在虚拟指针条件下，实习生的表现有显著提高（[公式：见文本]），而实习生则没有这种感觉。在最初的三回合中，培训师对两种条件下运动经济性的看法相似，但在第四回合中，虚拟指针条件下的看法有了显著改善（[公式：见文本]）。
结果表明，虚拟指针系统提高了培训师对实习生表现的感知，这反映在第三和第四轮培训中的客观表现测量上。虚拟指针和远程绘图系统的优势可能在培训的早期就被培训师所感知，但直到进一步掌握之后，才会在客观的实习生表现中显现出来。此外，运动经济性的表现改善表明，虚拟指针提高了专业视觉的采用——能够更直接地观察和使用腹腔镜视频结果，从而提高了手术技能。
