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A novel use of multi-perspective two-dimensional versus single perspective two-dimensional view in laparoscopy

Zachary Sanford, MD1, Robert Turner, PhD1, Ivan George1, Alex Addo, MD1, Helena Mentis, PhD2, Reza Zahiri, DO1, Adam S Weltz, MD1, Adrian Park1. 1Anne Arundel Medical Center, 2University of Maryland, Baltimore County

Introduction: Traditional laparoscopy uses a single-camera to provide solitary 2D-perspectives of a 3D-operative space, limiting vital depth cues and spatial awareness while potentially increasing mental workload and operative error. We present a novel study to characterize the impact of multiple simultaneous 2D-visual-perspectives on surgeons’ cognitive and physical workload in laparoscopy.

Methods: The effect of visualization on subjective visual comfort, mental workload, task proficiency, and ergonomic risk was prospectively investigated. Surgeons completed fundamental laparoscopic skills zip tie (ZT), pattern cut (PC), intracorporeal suture (IS) in single versus multi-perspective visualization. Baseline studies were conducted using configurations reflecting current laparoscopic displays while experimental design included three distinct and perpendicular 2D-visualizations (tip-of-the-scope, aerial, lateral perspectives). The NASA-TLX questionnaires was used to elicit subjective mental workload, visual comfort, and body pain/fatigue. Oculometry data were also recorded.

Results: Nine surgeons familiar with laparoscopy were recruited. No significant mental workload increase was noted from use of multiple versus single visual perspectives. Reductions in perceived mental and physical demand as well as effort and frustration were observed during the zip tie task (p < .05). Oculometry data suggest participants chiefly utilized tip-of-the-scope view (65% ZT, 72% PC, 74% IS) while periodically scanning the aerial perspective (25% ZT, 22% PC, 23% IS) and rarely incorporating the lateral perspective. Qualitative feedback indicates strong preference for the multi-perspective visual setup, especially for added aerial view.

Conclusions: Our findings demonstrate surgeons may benefit from multi-perspective visualization during laparoscopy. Additional work is required to explore potential benefits of multi-perspective visualization in optimizing movements and awareness in 3D-space.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95181

Program Number: P393

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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