Hewitson Christopher L, Crossley Matthew J, Cartmill John, Kaplan David M
Yale University, USA.
Macquarie University, Australia.
Hum Factors. 2025 Feb;67(2):141-165. doi: 10.1177/00187208241263684. Epub 2024 Jul 22.
This review surveys the literature on sensorimotor challenges impacting performance in laparoscopic minimally invasive surgery (MIS).
Despite its well-known benefits for patients, achieving proficiency in MIS can be challenging for surgeons due to many factors including altered visual perspectives and fulcrum effects in instrument handling. Research on these and other sensorimotor challenges has been hindered by imprecise terminology and the lack of a unified theoretical framework to guide research questions in the field.
We conducted a systematic survey of the MIS literature, focusing on studies investigating sensorimotor challenges affecting laparoscopic performance. To provide a common foundation for cross-study comparisons, we propose a standardized taxonomy that distinguishes between different experimental paradigms used in the literature. We then show how the computational motor learning perspective provides a unifying theoretical framework for the field that can facilitate progress and motivate future research along clearer, hypothesis-driven lines.
The survey identified diverse sensorimotor perturbations in MIS, which can be effectively categorized according to our proposed taxonomy. Studies investigating monitor-, camera-, and tool-based perturbations were systematically analyzed, elucidating their impact on surgical performance. We also show how the computational motor learning perspective provides deeper insights and potential strategies to mitigate challenges.
Sensorimotor challenges significantly impact MIS, necessitating a systematic, empirically informed approach. Our proposed taxonomy and theoretical framework shed light on the complexities involved, paving the way for more structured research and targeted training approaches to enhance surgical proficiency.
Understanding the sensorimotor challenges inherent to MIS can guide the design of improved training curricula and inform the configuration of setups in the operating room to enhance surgeon performance and ultimately patient outcomes. This review offers key insights for surgeons, educators, and researchers in surgical performance and technology development.
本综述调查了有关影响腹腔镜微创手术（MIS）操作的感觉运动挑战的文献。
尽管MIS对患者有诸多益处，但由于包括视觉视角改变和器械操作中的支点效应等多种因素，外科医生要熟练掌握MIS仍具有挑战性。对这些以及其他感觉运动挑战的研究因术语不精确以及缺乏统一的理论框架来指导该领域的研究问题而受到阻碍。
我们对MIS文献进行了系统调查，重点关注研究影响腹腔镜操作的感觉运动挑战的研究。为提供跨研究比较的共同基础，我们提出了一种标准化分类法，以区分文献中使用的不同实验范式。然后我们展示了计算运动学习视角如何为该领域提供一个统一的理论框架，这可以促进进展并推动未来沿着更清晰、由假设驱动的方向进行研究。
该调查确定了MIS中各种感觉运动扰动，根据我们提出的分类法可以有效地对其进行分类。对研究基于监视器、摄像头和工具的扰动的研究进行了系统分析，阐明了它们对手术操作的影响。我们还展示了计算运动学习视角如何提供更深入的见解和潜在策略来应对挑战。
感觉运动挑战对MIS有重大影响，需要一种系统的、基于实证的方法。我们提出的分类法和理论框架揭示了其中涉及的复杂性，为更具结构性的研究和针对性的培训方法铺平了道路，以提高手术熟练程度。
了解MIS固有的感觉运动挑战可以指导改进培训课程的设计，并为手术室设置的配置提供信息，以提高外科医生的表现并最终改善患者的治疗结果。本综述为外科医生、教育工作者以及手术操作和技术开发方面的研究人员提供了关键见解。
