Comparing endoscopic systems on two simulated tasks

Abstract

Endoscopes are slender instruments for performing medical procedures through small incisions or natural body orifices. Three experiments examined the performance effects of various endoscope systems when naive participants executed tasks in a bladder-like environment. The systems involved a direct endoscope, requiring the user to look through a lens at the outer part of the endoscope, and a video endoscope that picks up the image via a camera attached to the endoscope and displays it on a video monitor. The results indicate that the participants performed the tasks better with video than with direct endoscopes, and showed more transfer of practice with video endoscopic surgery from a small to a large task environment than vice versa. The optimal position of the monitor with video endoscopic surgery appeared to involve a reasonable angle relative to the operating area (45° was used). Performance was less at a greater angle (90°), but also at a small angle (10°). It did not matter whether the monitor was located left, right or above the operating area. As performance did not fully transfer to differently sized task environments, endoscopists should initially train with task environments of different, and especially small, sizes.

Keywords:

• Endoscopy
• Fulcrum effect
• Minimal invasive surgery
• Movement skills

Acknowledgements

Thanks are due to A. Luttmann, J. Sökeland (both at the Institut für Arbeitsphysiologie Dormund, Germany), and B. van Leeuwaarden (formerly at the Medical Centre Molendael, Baarn, the Netherlands) for discussions on the topic and to A. Luttmann and J. Sökeland for providing the endoscopic surgery system. The contribution of P. Wallmeyer in running the experiments is also acknowledged.