Abstract
Laparoscopy is a minimally invasive surgery practiced through small incisions in the body, and requiring the use of long-reach instruments and a camera. Since the video feed is displayed on a monitor, depth perception can be significantly altered, and it is hypothesized that such alterations may depend on the relative position of the monitor with respect to the operator. The objective of this study was to explore the relationship between monitor positioning and human performance in laparoscopic tasks. A total of eight male subjects volunteered to perform a variety of simulated laparoscopic tasks including object transfers, precision cutting, and suturing while three different monitor configurations were used (i.e., left, center, and right of the user). Tool trajectory was monitored using a motion capturing system, and task performance was evaluated using human performance quantitative metrics including completion time, depth of penetration, path length, axial speed, and motion smoothness. Results showed that human performance significantly increased when monitor location was centered with respect to the user during precision cutting. Moreover, subjects’ performance decreased when the monitor was placed on their dominant-hand side. The findings of this study suggest ergonomic guidelines for optimizing human performance in simulated and actual laparoscopic tasks. Specifically, placing the monitor in a central position with respect to the user should represent the standard configuration while conducting laparoscopy.
Highlights
Laparoscopy is a type of minimally invasive surgery performed through small incisions in the abdomen or pelvis; it is the most common operation for cholecystectomy [1], with close to 700,000 of these procedures performed each year [2]
The procedure and methods used in this study were approved by the Internal Review Board (IRB) at the University of Miami
The two-way repeated measures analysis of variance (ANOVA) models involving task and monitor placement did not reveal a significant effect on performance due to monitor placement
Summary
Laparoscopy is a type of minimally invasive surgery performed through small incisions in the abdomen or pelvis; it is the most common operation for cholecystectomy [1], with close to 700,000 of these procedures performed each year [2]. Since surgeons cannot use their hands directly to operate as in open surgery, long-reach instruments are required to perform laparoscopy. The video feed is displayed on an external monitor, giving the surgeon the necessary vision to perform the operation. This type of remote viewing significantly alters depth perception [3], adding to the challenge of maneuvering laparoscopic instruments during a procedure. Concerns about a surgeon’s performance in laparoscopy due to the effects of visual configuration have motivated significant research in this area [4,5,6,7]
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