Krois Wilfried, Reck-Burneo Carlos A, Gröpel Peter, Wagner Michael, Berger Angelika, Metzelder Martin L
Division of Surgery, Clinical Department of Pediatric Surgery, Medical University of Vienna, Vienna, Austria.
Division of Sport Psychology, Department of Sport Science, University of Vienna, Austria.
J Laparoendosc Adv Surg Tech A. 2020 May;30(5):564-568. doi: 10.1089/lap.2019.0736. Epub 2020 Mar 24.
Training in laparoscopic surgery seems to be an important aspect in gaining and maintaining professional competency. In experimental settings, camera navigation skills improved after simulation-based training, but the effect of camera work on the surgeon's performance is not well studied. The aim of this study was to investigate whether a fixed camera or an operated camera, as well as the experience of the camera operator has an effect on the performance of the surgeon. The study was performed on the LapSim laparoscopic training system. The task was to tie an intracorporal knot in a static surgical environment with three different camera conditions: fixed camera, camera operated by an inexperienced person (inexpert camera), and camera operated by an experienced surgeon (expert camera). The camera conditions were counterbalanced across trials. Performance variables were completion time in seconds and the extend of movements in path length and angular pathway. Gaze behavior was measured with eye-tracking glasses worn by the surgeon as well as the camera operator and was evaluated for performance-harming effects. Completion time varied across conditions, with participants performing significantly longer in the fixed camera condition than in the expert or the inexpert condition. The expert and inexpert conditions did not differ. The performance-harming effect of non-focusing on the tissue was especially visible in the fixed camera condition but disappeared in the expert camera condition. Neither the camera operators' gaze behavior nor the surgeon-camera operator fixation agreement predicted task performance. A camera operator can potentially eliminate performance-harming effects of maladaptive gaze behavior and promote optimal visual behavior of a surgeon. In our experimental task, there was no significant difference in whether the camera operator had previous training in laparoscopic surgery or not.
腹腔镜手术培训似乎是获得并保持专业能力的一个重要方面。在实验环境中，基于模拟的培训后摄像头导航技能有所提高，但摄像头操作对外科医生手术表现的影响尚未得到充分研究。本研究的目的是调查固定摄像头或由人操作的摄像头，以及摄像头操作者的经验是否会对外科医生的表现产生影响。该研究在LapSim腹腔镜培训系统上进行。任务是在静态手术环境中，在三种不同的摄像头条件下打一个体内结：固定摄像头、由无经验人员操作的摄像头（非专业摄像头）和由经验丰富的外科医生操作的摄像头（专业摄像头）。摄像头条件在各试验中进行了平衡。性能变量包括以秒为单位的完成时间以及路径长度和角度路径上的运动范围。通过外科医生和摄像头操作者佩戴的眼动追踪眼镜测量注视行为，并评估其对手术表现的有害影响。完成时间因条件而异，参与者在固定摄像头条件下的操作时间明显长于在专业或非专业条件下的操作时间。专业和非专业条件之间没有差异。在固定摄像头条件下，不聚焦于组织对手术表现的有害影响尤为明显，但在专业摄像头条件下则消失了。摄像头操作者的注视行为和外科医生与摄像头操作者的注视一致性均未预测任务表现。摄像头操作者有可能消除适应不良注视行为对手术表现的有害影响，并促进外科医生的最佳视觉行为。在我们的实验任务中，摄像头操作者之前是否接受过腹腔镜手术培训没有显著差异。
