title: Adapting to the 30-degree visual perspective by emulating the angled laparoscope: a simple and low-cost solution for basic surgical training.
abstract: BACKGROUND
  The ability to handle and adapt to the visual perspectives generated by angled laparoscopes is crucial for skilled laparoscopic surgery. However, the control of the visual work space depends on the ability of the operator of the camera, who is often not the most experienced member of the surgical team. Here, we present a simple, low-cost option for surgical training that challenges the learner with static and dynamic visual perspectives at 30 degrees using a system that emulates the angled laparoscope.
  
  
  METHODS
  A system was developed using a low-cost camera and readily available materials to emulate the angled laparoscope. Nine participants undertook 3 tasks to test spatial adaptation to the static and dynamic visual perspectives at 30 degrees. Completing each task to a predefined satisfactory level ensured precision of execution of the tasks. Associated metrics (time and error rate) were recorded, and the performance of participants were determined.
  
  
  RESULTS
  A total of 450 repetitions were performed by 9 residents at various stages of training. All the tasks were performed with a visual perspective of 30 degrees using the system. Junior residents were more proficient than senior residents.
  
  
  CONCLUSIONS
  This system is a viable and low-cost alternative for developing the basic psychomotor skills necessary for the handling and adaptation to visual perspectives of 30 degrees, without depending on a laparoscopic tower, in junior residents. More advanced skills may then be acquired by other means, such as in the operating theater or through clinical experience.
authors.affiliation: From the University Hospital of the Autonomous University of Nuevo León (F.M.T.), Monterrey; and Bioelectronics Section (L.E.D.,M.M.A.), Department of Electrical Engineering, CINVESTAV (Research and Advanced Studies Center of the National Polytechnic Institute); and Department of General Pediatric Surgery (O.F.R.), Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
authors.forename: Lorias Espinoza
authors.initials: LE
authors.lastname: Daniel
authors.forename: Fernando Montes
authors.initials: FM
authors.lastname: Tapia
authors.forename: Minor Martínez
authors.initials: MM
authors.lastname: Arturo
authors.forename: Ordorica Flores
authors.initials: OF
authors.lastname: Ricardo
mesh_terms: D003362:Cost-Benefit Analysis; D004867:Equipment Design; D006801:Humans; D007318:Inservice Training / Q000191:economics / Q000379:methods*; D020706:Laparoscopes; D010535:Laparoscopy / Q000193:education* / Q000295:instrumentation; D065855:Spatial Processing; D013647:Task Performance and Analysis