Department of Surgery, Radboud University Medical Center, PO Box 9101 (960), Nijmegen, 6500 HB, The Netherlands.
BMC Med Educ. 2023 Aug 29;23(1):613. doi: 10.1186/s12909-023-04555-z.
Deviated optical angles create visuospatial and psychomotor challenges during laparoscopic procedures, resulting in delayed operative time and possibly adverse events. If it is possible to train the skills needed to work under these deviated optical angles, this could benefit procedure time and patient safety. This study investigates the influence of the optical angle on development of basic laparoscopic surgical skills.
A total of 58 medical students performed a four-session laparoscopic training course on a Virtual Reality Simulator. During each session, they performed an identical task under optical angles of 0°, 45° and - 45°. Performance parameters of task duration and damage were compared between the optical angles to investigate the effect of optical angle on performance development. The 4th session performance was compared to the 2nd session performance for each angle to determine improvement.
Participants performed the task significantly faster under the 0° optical angle compared to the plus and minus 45° optical angles during the last three sessions (z between - 2.95 and - 2.09, p < .05). Participants improved significantly and similarly for task duration during the training course under all optical angles. At the end of the training course however significant performance differences between the zero and plus/minus 45 optical angles remained. Performance for damage did not improve and was not affected by optical angle throughout the course.
Dedicated virtual reality training improves laparoscopic basic skills performance under deviated optical angles as it leads to shorter task duration, however a lasting performance impairment compared to the 0° optical angle remained. Training for performing under deviating optical angles can potentially shorter the learning curve in the operating room.
腹腔镜手术中，偏离的视轴会带来空间感知和动作协调方面的挑战，导致手术时间延长，并可能引发不良事件。如果能够对在这些偏离视轴下工作所需的技能进行训练，那么这将有助于缩短手术时间并提高患者安全性。本研究旨在探讨视轴角度对基础腹腔镜手术技能发展的影响。
共有 58 名医学生在虚拟现实模拟器上进行了四节腹腔镜培训课程。在每节课中，他们在 0°、45°和-45°的视轴角度下完成相同的任务。通过比较不同视轴角度下的任务持续时间和损伤等绩效参数，研究视轴角度对绩效发展的影响。将每个角度的第 4 节课表现与第 2 节课表现进行比较，以确定改进情况。
在最后三节课中，参与者在 0°视轴角度下完成任务的速度明显快于 45°和-45°视轴角度（z 值介于-2.95 到-2.09 之间，p<0.05）。在整个培训过程中，参与者在所有视轴角度下的任务持续时间都有显著提高，且提高幅度相似。然而，在培训课程结束时，0°视轴角度与 45°和-45°视轴角度之间仍存在显著的绩效差异。在整个培训过程中，损伤的绩效没有提高，也不受视轴角度的影响。
专门的虚拟现实培训可以提高偏离视轴下的腹腔镜基本技能表现，因为它可以缩短任务持续时间，但与 0°视轴角度相比，仍存在持久的绩效障碍。针对偏离视轴操作的培训可能会缩短手术室的学习曲线。
