Joint Attention in a Laparoscopic Simulation-Based Training: A Pilot Study on Camera Work, Gaze Behavior, and...

Area of Science:

• Surgical Simulation
• Medical Education
• Human Factors Engineering

Background:

• Laparoscopic surgery training is crucial for competency.
• Simulation-based training enhances camera navigation skills.
• The impact of camera operation on surgeon performance requires further study.

Purpose of the Study:

• To evaluate the effect of camera operation (fixed, inexpert, expert) on surgeon performance.
• To determine if camera operator experience influences surgical outcomes.
• To analyze gaze behavior and its impact on performance in laparoscopic surgery.

Main Methods:

• Utilized the LapSim laparoscopic training system for an intracorporal knot-tying task.
• Compared three camera conditions: fixed, inexpert operator, and expert operator.
• Measured performance via completion time, movement extent, and eye-tracking data for surgeons and camera operators.

Main Results:

• Surgeons performed significantly faster with an operated camera (expert or inexpert) versus a fixed camera.
• The fixed camera condition exacerbated performance-harming effects of maladaptive gaze.
• Camera operator experience or gaze behavior did not significantly impact task performance in this study.

Conclusions:

• A dedicated camera operator can mitigate performance-harming gaze behaviors in laparoscopic surgery.
• Surgeon performance is enhanced by an operated camera, regardless of the operator's prior laparoscopic training.
• Optimizing visual feedback through camera operation is key to improving surgical performance.