title: Adaptation to a dynamic visual perspective in laparoscopy through training in the cutting task.
abstract: BACKGROUND
  Laparoscopic surgery demands of surgeons special skills acquired only through practice. Laparoscopic training systems traditionally have an optical system that, once positioned, remains fixed and cannot refresh the perspective unless the task is interrupted and the camera repositioned. During a surgery, the visual perspective changes constantly to relocate the surgical target. This difference is a limitation for any novice surgeon. This report proposes the use of a mechatronic system that allows the trainee to handle optics dynamically during training in the cutting task and thereby adapt to dynamic relocation of the surgical target.
  
  
  METHODS
  The study was conducted in two phases. The first phase involved using fixed optics to cut a circle drawn on a piece of cloth. The second phase involved the same cutting task but with the visual perspective changed dynamically by the user via a mechatronic assistant.
  
  
  RESULTS
  The data show that by adapting to dynamic optics, medical trainees can quickly and easily handle and locate the task with real-time changes in visual perspective and can also improve task quality. A significant statistical difference was found between the two methods performed (p < 0.0025). Variance analysis also was applied to the mean values of the scores achieved by both groups (p < 0.0001).
  
  
  CONCLUSIONS
  A new laparoscopic training method has been developed. It applies real-time dynamic optics that trainees assist by means of a mechatronic device harnessed to their body. This new training tool allows resident trainees to adapt quickly to the work environment of dynamic optics and thus enter the surgical scenario more rapidly and confidently after mastering the visual-spatial aspect of the laparoscopic approach.
authors.affiliation: Bioelectronics Section, Centro de Investigación y Estudios Avanzados IPN, Av IPN 2508, CP 073000 Mexico City, Mexico. aminor@cinvestav.mx
authors.forename: Arturo Minor
authors.initials: AM
authors.lastname: Martínez
authors.forename: José Luis Limón
authors.initials: JL
authors.lastname: Aguilar
authors.forename: Ricardo Ordorica
authors.initials: RO
authors.lastname: Flores
authors.forename: José Luis Ortiz
authors.initials: JL
authors.lastname: Simón
authors.forename: Alejandro García
authors.initials: AG
authors.lastname: Pérez
mesh_terms: D000221:Adaptation, Ocular / Q000502:physiology*; D002983:Clinical Competence; D003198:Computer Simulation; D004502:Education, Medical, Continuing / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods*; D014796:Visual Perception / Q000502:physiology*