Soft-light overhead illumination systems improve laparoscopic task performance.
OBJECTIVE
The aim of this study was to evaluate the impact of attached shadow cues for laparoscopic task performance.


METHODS
We developed a soft-light overhead illumination system (SOIS) that produced attached shadows on objects. We compared results using the SOIS with those using a conventional illumination system with regard to laparoscopic experience and laparoscope-to-target distances (LTDs). Forty-two medical students and 23 surgeons participated in the study. A peg transfer task (LTD, 120 mm) for students and surgeons, and a suture removal task (LTD, 30 mm) for students were performed. Illumination systems were randomly assigned to each task. Endpoints were: total number of peg transfers; percentage of peg-dropping errors; and total execution time for suture removal. After the task, participants filled out a questionnaire on their preference for a particular illumination system.


RESULTS
Total number of peg transfers was greater with the SOIS for both students and surgeons. Percentage of peg-dropping errors for surgeons was lower with the SOIS. Total execution time for suture removal was shorter with the SOIS. Forty-five participants (69% in total) evaluated the SOIS for easier task performance.


CONCLUSIONS
The present results confirm that the SOIS improves laparoscopic task performance, regardless of previous laparoscopic experience or LTD.
*Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Ehime University Graduate School of Medicine, Toon †Department of Electrical and Electronic Engineering, Ehime University and Graduate School of Ehime University, Matsuyama, Ehime ‡Translational Research Center, Kyoto University Hospital, Kyoto, Japan.
Akihiro
A
Takai
Yasutsugu
Y
Takada
Hideki
H
Motomura
Satoshi
S
Teramukai
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003463:Cues; D004867:Equipment Design; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008029:Lighting / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D013647:Task Performance and Analysis; D014796:Visual Perception; D055815:Young Adult