title: Effect of video lag on laparoscopic surgery: correlation between performance and usability at low latencies.
abstract: BACKGROUND
  Few telesurgery studies assess the impact of latency on user experience, low latencies are often not studied despite evidence of negative effects, and some studies recruit inexperienced subjects instead of surgeons without evidence that latency affects both groups similarly.
  
  
  METHODS
  Fifteen trainees and fourteen laparoscopic surgeons conducted two tasks on a laparoscopy home-trainer at six latencies below 200 milliseconds (ms). Completion time and usability (perceived awareness of latency, inefficiency, disturbance, adaptability, and impact on patient safety) were measured.
  
  
  RESULTS
  Weak correlation between completion time and usability was found. There was significant deterioration in performance and user experience at 105 ms added latency. Surgeons were more negatively affected.
  
  
  CONCLUSIONS
  Objective measures insufficiently describe the impact of latency therefore standard measures of user experience should be incorporated in studies. Even low latencies may be detrimental to laparoscopic surgery. Results from non-experts cannot predict the impact of latency on experienced surgeons. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: iMinds-TELIN-IPI, Ghent University, Ghent, Belgium.
authors.forename: Asli
authors.identifier: http://orcid.org/0000-0002-5144-1258
authors.initials: A
authors.lastname: Kumcu
authors.affiliation: iMinds-MICT, Ghent University, Ghent, Belgium.
authors.forename: Lotte
authors.initials: L
authors.lastname: Vermeulen
authors.affiliation: iMinds-SMIT, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Shirley A
authors.initials: SA
authors.lastname: Elprama
authors.affiliation: iMinds-SMIT, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Duysburgh
authors.affiliation: iMinds-TELIN-IPI, Ghent University, Ghent, Belgium.
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Platiša
authors.affiliation: Department of Gastrointestinal Surgery, University Hospital Ghent, Ghent, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Van Nieuwenhove
authors.affiliation: Department of Abdominal Surgery, University Hospital Brussel, Brussels, Belgium.
authors.forename: Nele
authors.initials: N
authors.lastname: Van De Winkel
authors.affiliation: iMinds-SMIT, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: An
authors.initials: A
authors.lastname: Jacobs
authors.affiliation: iMinds-MICT, Ghent University, Ghent, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Van Looy
authors.affiliation: iMinds-TELIN-IPI, Ghent University, Ghent, Belgium.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Philips
mesh_terms: D016477:Artifacts; D002983:Clinical Competence; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods; D008297:Male; D061646:Operative Time; D015203:Reproducibility of Results; D065287:Robotic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D013647:Task Performance and Analysis; D013997:Time Factors; D014741:Video Recording / Q000295:instrumentation* / Q000379:methods
keywords: human factors; laparoscopy; latency; quality of experience; telesurgery; usability; video lag