Ameer Alhusuny1, Margaret Cook2, Akram Khalil3,4, Julia Treleaven5, Andrew Hill6,7,8, Venerina Johnston9. 1. School of Health and Rehabilitation Sciences, The University of Queensland, Level 3, Therapies Annexe Building 84, St Lucia, Brisbane, QLD, 4068, Australia. a.alhusuny@uq.edu.au. 2. School of Earth and Environmental Sciences, Faculty of Science, The University of Queensland, Brisbane, Australia. 3. Faculty of Medicine, The University of Queensland, Brisbane, Australia. 4. Royal Brisbane and Women's Hospital, Brisbane, Australia. 5. School of Health and Rehabilitation Sciences, The University of Queensland, Level 3, Therapies Annexe Building 84, St Lucia, Brisbane, QLD, 4068, Australia. 6. Clinical Skills Development Service, Metro North Hospital and Health Service, Brisbane, Australia. 7. Minerals Industry Safety & Health Centre, Sustainable Minerals Institute, The University of Queensland, Brisbane, Australia. 8. School of Psychology, The University of Queensland, Brisbane, Australia. 9. RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia.
Abstract
BACKGROUND: Minimally invasive surgery (MIS) is not without impact on surgeons' neck/shoulder/head and eyes. However, the mechanisms for concurrent symptoms are not clear. This study aims to examine the effect of visual impairments on physical symptoms and surgical performance among surgeons performing simulated surgical tasks using two-dimensional (2D) and three-dimensional (3D) viewing modes. METHODS: Gynaecologists with experience in laparoscopy performed four simulated surgical tasks in the 2D and 3D viewing modes. Visual parameters (accommodation, convergence and stereoacuity) were measured prior to commencement. Objective performance measures were derived from the laparoscopic tasks, and surgeons also self-reported their mental and physical workload using the NASA-TLX. In addition, perceived symptoms were measured using Visual Analogue Scales, the Simulator Sickness Questionnaire and the Computer Vision Syndrome Questionnaire. RESULTS: Seventeen healthy gynaecologists participated in this study. There were significant relationships between visual impairments and both the perceived symptoms and surgical performance scores of MIS surgeons. Surgeons with a higher number of accommodation/convergence dysfunctions and/or poorer stereoacuity tended to have poorer objective performance scores on simulated surgical tasks in both viewing modes. NASA-TLX scores indicated that surgeons with poorer stereoacuity also perceived themselves to have been less successful at accomplishing tasks. However, these surgeons also reported less intense physical symptoms and simulator sickness. CONCLUSIONS: Surgeons' performance for the simulated surgical tasks correlated with visual functions, and it also impacted on the symptoms experienced. Regular screening of surgeons' vision and vision therapy may be required to decrease physical symptoms and improve surgical performance.
BACKGROUND: Minimally invasive surgery (MIS) is not without impact on surgeons' neck/shoulder/head and eyes. However, the mechanisms for concurrent symptoms are not clear. This study aims to examine the effect of visual impairments on physical symptoms and surgical performance among surgeons performing simulated surgical tasks using two-dimensional (2D) and three-dimensional (3D) viewing modes. METHODS: Gynaecologists with experience in laparoscopy performed four simulated surgical tasks in the 2D and 3D viewing modes. Visual parameters (accommodation, convergence and stereoacuity) were measured prior to commencement. Objective performance measures were derived from the laparoscopic tasks, and surgeons also self-reported their mental and physical workload using the NASA-TLX. In addition, perceived symptoms were measured using Visual Analogue Scales, the Simulator Sickness Questionnaire and the Computer Vision Syndrome Questionnaire. RESULTS: Seventeen healthy gynaecologists participated in this study. There were significant relationships between visual impairments and both the perceived symptoms and surgical performance scores of MIS surgeons. Surgeons with a higher number of accommodation/convergence dysfunctions and/or poorer stereoacuity tended to have poorer objective performance scores on simulated surgical tasks in both viewing modes. NASA-TLX scores indicated that surgeons with poorer stereoacuity also perceived themselves to have been less successful at accomplishing tasks. However, these surgeons also reported less intense physical symptoms and simulator sickness. CONCLUSIONS: Surgeons' performance for the simulated surgical tasks correlated with visual functions, and it also impacted on the symptoms experienced. Regular screening of surgeons' vision and vision therapy may be required to decrease physical symptoms and improve surgical performance.
Authors: Charlotte Fergo; Jakob Burcharth; Hans-Christian Pommergaard; Niels Kildebro; Jacob Rosenberg Journal: Am J Surg Date: 2016-08-31 Impact factor: 2.565