A virtual pointer to support the adoption of professional vision in laparoscopic training
A virtual pointer to support the adoption of professional vision in laparoscopic training
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DOI：
10.1007/s11548-018-1792-9
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发表时间：
2018-09-01
影响因子：
3
通讯作者：
Mentis, Helena M.
中科院分区：
文献类型：
--
作者：
Feng, Yuanyuan;McGowan, Hannah;Mentis, Helena M.
目的评价一种支持外科实习生在腹腔镜手术中发展专业视力的虚拟指标。方法我们开发了一个虚拟指点和遥控系统，利用Microsoft Kinect运动传感器作为任何成像系统的覆盖物。在腹腔镜训练环境中，将该应用程序的训练与标准条件进行比较，即使用非介入性手势进行口头指导。7名受训者在一名经验丰富的外科医生的指导下进行了四次模拟腹腔镜术任务。受训者和培训师对受训者的表现进行主观评估，并通过错误次数、完成任务的时间和移动的经济性来客观地衡量受训者的表现。结果虚拟指针组与标准指针组在误差和任务完成时间上无显著差异。使用虚拟指针时，非优势手的运动经济性显著提高(p=0.012)。受训者感觉到受训者在虚拟指针条件下的表现有显著提高(P<；0.001)，而受训者没有感觉到差异。教练员对运动经济性的感知在前三次跑中两种情况下相似，在第四次跑中在虚拟指针状态下显著提高(p=0.017)。结论虚拟指点系统提高了教练员对学员成绩的感知，并体现在第三、四轮训练的客观成绩测评中。虚拟指点和远程传送系统的好处可能在培训早期就被培训者察觉到，但这在学员的客观表现中并不明显，直到获得进一步的掌握。此外，运动经济性的性能提升具体表现为虚拟指针提高了对专业视觉的采用--提高了观看和使用腹腔镜视频的能力，从而导致了更直接的器械运动。
Purpose To assess a virtual pointer in supporting surgical trainees' development of professional vision in laparoscopic surgery. Methods We developed a virtual pointing and telestration system utilizing the Microsoft Kinect movement sensor as an overlay for any imagine system. Training with the application was compared to a standard condition, i. e., verbal instruction with un-mediated gestures, in a laparoscopic training environment. Seven trainees performed four simulated laparoscopic tasks guided by an experienced surgeon as the trainer. Trainee performance was subjectively assessed by the trainee and trainer, and objectively measured by number of errors, time to task completion, and economy of movement. Results No significant differences in errors and time to task completion were obtained between virtual pointer and standard conditions. Economy of movement in the non-dominant hand was significantly improved when using virtual pointer (p = 0.012). The trainers perceived a significant improvement in trainee performance in virtual pointer condition (p < 0.001), while the trainees perceived no difference. The trainers' perception of economy of movement was similar between the two conditions in the initial three runs and became significantly improved in virtual pointer condition in the fourth run (p = 0.017). Conclusions Results show that the virtual pointer system improves the trainer's perception of trainee's performance and this is reflected in the objective performance measures in the third and fourth training runs. The benefit of a virtual pointing and telestration systemmay be perceived by the trainers early on in training, but this is not evident in objective trainee performance until further mastery has been attained. In addition, the performance improvement of economy of motion specifically shows that the virtual pointer improves the adoption of professional vision-improved ability to see and use laparoscopic video results in more direct instrument movement.