Abstract
Expertise in laparoscopic surgery is realized through both manual dexterity and efficient eye movement patterns, creating opportunities to use gaze information in the educational process. To better understand how expert gaze behaviors are acquired through deliberate practice of technical skills, three surgeons were assessed and five novices were trained and assessed in a 5-visit protocol on the Fundamentals of Laparoscopic Surgery peg transfer task. The task was adjusted to have a fixed action sequence to allow recordings of dwell durations based on pre-defined areas of interest (AOIs). Trained novices were shown to reach more than 98% (M = 98.62%, SD = 1.06%) of their behavioral learning plateaus, leading to equivalent behavioral performance to that of surgeons. Despite this equivalence in behavioral performance, surgeons continued to show significantly shorter dwell durations at visual targets of current actions and longer dwell durations at future steps in the action sequence than trained novices (ps ≤ .03, Cohen’s ds > 2). This study demonstrates that, while novices can train to match surgeons on behavioral performance, their gaze pattern is still less efficient than that of surgeons, motivating surgical training programs to involve eye tracking technology in their design and evaluation.
Highlights
Laparoscopic surgery is a type of minimally invasive surgery in which narrow tubes are inserted into the body through small incisions, allowing surgeons to manipulate, cut, and sew tissue with relatively less trauma, leading to faster patient recovery and lower morbidity compared to open surgical techniques (Fuchs, 2002)
This study demonstrates that, while novices can train to match surgeons on behavioral performance, their gaze pattern is still less efficient than that of surgeons, motivating surgical training programs to involve eye tracking technology in their design and evaluation
This study aimed to extend previous research applying eye tracking technology to understand expertise and skill acquisition in laparoscopic surgery
Summary
Laparoscopic surgery is a type of minimally invasive surgery in which narrow tubes are inserted into the body through small incisions, allowing surgeons to manipulate, cut, and sew tissue with relatively less trauma, leading to faster patient recovery and lower morbidity compared to open surgical techniques (Fuchs, 2002). G. (2021) Developing expert gaze pattern in laparoscopic surgery requires more than behavioral training create challenges for surgeons. Successful laparoscopic surgery entails expertise in depth perception from 2-dimensional images, as well as complex visual-motor coordination and transformation, among other important skills. Even though all these skills can be reasonably trained in existing and validated simulation programs (Fried et al, 2004), such training takes a substantial amount of time from surgical trainees who are regularly fatigued from other professional commitments and face restricted working hours (Ahmed et al, 2014). An important need exists to further improve the efficiency of training programs in laparoscopic surgery, motivating research to characterize the gaps between experts and non-experts and innovation to create effective interventions to minimize such gaps
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