Literature DB >> 17436042

Optimizing laparoscopic task efficiency: the role of camera and monitor positions.

Liam A Haveran1, Yuri W Novitsky, Donald R Czerniach, Gordie K Kaban, Melinda Taylor, Karen Gallagher-Dorval, Richard Schmidt, John J Kelly, Demetrius E M Litwin.   

Abstract

BACKGROUND: Alterations of video monitor and laparoscopic camera position may create perceptual distortion of the operative field, possibly leading to decreased laparoscopic efficiency. We aimed to determine the influence of monitor/camera position on the laparoscopic performance of surgeons of varying skill levels.
METHODS: Twelve experienced and 12 novice participants performed a one-handed task with their dominant hand in a modified laparoscopic trainer. Initially, the camera was fixed directly in front of the participant (0 degrees) and the monitor location was varied between three positions, to the left of midline (120 degrees), directly across from the participant (180 degrees), and to the right of the midline (240 degrees). In the second experiment monitor position was constant straight across from the participant (180 degrees) while the camera position was adjusted between the center position (0 degrees), to the left of midline (60 degrees), and to the right of midline (300 degrees). Participants completed five trials in each monitor/camera setting. The significance of the effects of skill level and combinations of camera and monitor angle were evaluated by analysis of variance (ANOVA) for repeated measures using restricted maximum likelihood estimation.
RESULTS: Experienced surgeons completed the task significantly faster at all monitor/camera positions. The best performance in both groups was observed when the monitor and camera were located at 180 degrees and 0 degrees, respectively. Monitor positioning to the right of midline (240 degrees) resulted in significantly worse performance compared to 180 degrees for both experienced and novice surgeons. Compared to 0 degrees (center), camera position to the left or the right resulted in significantly prolonged task times for both groups. Novice subjects also demonstrated a significantly lower ability to adjust to suboptimal camera/monitor positions.
CONCLUSION: Experienced subjects demonstrated superior performance under all study conditions. Optimally, the camera should be directly in front and the monitor should be directly across from a surgeon. Alternatively, the monitor/camera could be placed opposite to the surgeon's non-dominant hand. The suboptimal camera/monitor conditions are especially difficult to overcome for inexperienced subjects. Monitor and camera positioning must be emphasized to ensure optimal laparoscopic performance.

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Year:  2007        PMID: 17436042     DOI: 10.1007/s00464-007-9360-3

Source DB:  PubMed          Journal:  Surg Endosc        ISSN: 0930-2794            Impact factor:   4.584


  16 in total

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2.  Monitor height affects surgeons' stress level and performance on minimally invasive surgery tasks.

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4.  Monitor position in laparoscopic surgery.

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5.  The role of mental rotation and memory scanning on the performance of laparoscopic skills: a study on the effect of camera rotational angle.

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8.  Ergonomic principles of task alignment, visual display, and direction of execution of laparoscopic bowel suturing.

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9.  Screen height as an ergonomic factor in laparoscopic surgery.

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  16 in total

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2.  Ergonomics in thoracoscopic surgery: results of a survey among thoracic surgeons.

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3.  Effects of laparoscopic instrument and finger on force perception: a first step towards laparoscopic force-skills training.

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6.  Ergonomics in Endoscopic Transsphenoidal Surgery: A Survey of the North American Skull Base Society.

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Review 7.  Optimal ergonomics for laparoscopic surgery in minimally invasive surgery suites: a review and guidelines.

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Review 8.  Surgical ergonomics for urologists: a practical guide.

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