title: Another use of the mobile device: warm-up for laparoscopic surgery.
abstract: BACKGROUND
  An important facet of laparoscopic surgery is its psychomotor component. As this aspect of surgery gains attention, lessons from other psychomotor-intense fields such as athletics have led to an investigation of the benefits of "warming up" prior to entering the operating room. Practical implementation of established methods of warm-up is hampered by a reliance on special equipment and instrumentations that are not readily available. In light of emerging evidence of translatability between video-game play and operative performance, we sought to find if laparoscopic task performance improved after warming up on a mobile device balance game.
  
  
  METHODS
  Laparoscopic novices were randomized into either the intervention group (n = 20) or the control group (n = 20). The intervention group played a mobile device balance game for 10 min while the control group did no warm-up whatsoever. Assessment was performed using two tasks on the ProMIS laparoscopic simulation system: "object positioning" (where small beads are transferred between four cups) and "tissue manipulation" (where pieces of plastic are stretched over pegs). Metrics measured were time to task completion, path length, smoothness, hand dominance, and errors.
  
  
  RESULTS
  The intervention group made fewer errors: object positioning task 0.20 versus 0.70, P = 0.01, tissue manipulation task 0.15 versus 0.55, P = 0.05, total errors 0.35 versus 1.25, P = 0.002. The two groups performed similarly on the other metrics.
  
  
  CONCLUSIONS
  Warm-up using a mobile device balance game decreases errors on basic tasks performed on a laparoscopic surgery simulator, suggesting a practical way to warm-up prior to cases in the operating room.
authors.affiliation: Department of Surgery, Stanford University, Stanford, California 94305-5641, USA. plerhopl@stanford.edu
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Plerhoples
authors.forename: Yulia
authors.initials: Y
authors.lastname: Zak
authors.forename: Tina
authors.initials: T
authors.lastname: Hernandez-Boussard
authors.forename: James
authors.initials: J
authors.lastname: Lau
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D007839:Functional Laterality; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010535:Laparoscopy / Q000193:education* / Q000592:standards; D008297:Male; D011597:Psychomotor Performance; D011897:Random Allocation; D018910:Video Games