LaparscopyVideo-assisted surgery represents more than a loss of three-dimensional vision
Section snippets
Subjects
Twenty-four medical students with no previous experience in MIS were randomly assigned to perform a validated [2], [3] basic MIS task under either binocular direct vision (BDV) (5 male, 3 females, mean age 21.5 years), monocular direct vision (MDV) (4 males, 4 females, mean age 22.9 years) with the nondominant eye covered by a simple elastic patch, or binocular VI (4 males, 4 females, mean age 23.3 years) conditions. Novices were selected to provide the purest comparison of imaging modalities
Results
Figure 1 shows the mean number of correct incisions made by the subjects in each group for the first, fifth, and tenth trials. Differences between the means of the groups were examined by using 2-factor analysis of variance for repeated measures where factor 1 was group and factor 2 was trials. To simplify analysis, trails 1, 5, and 10 were chosen to represent the trend in performance throughout the 10 trials. The results show that, for each trial, the BDV group made more correct incisions than
Comments
Understanding the results of this study requires a brief review of human visual perception [9]. When we view our environment, we rely on a variety of distance cues that allow us to interpret and determine the location of objects that we see in space. These cues can be divided into 2 main types: binocular cues, requiring stimulation of both eyes, and monocular cues, which do not change whether viewed by 1 or both eyes.
The binocular cue that is most important to perception is known as retinal
References (12)
- et al.
The role of binocular vision in prehensionA kinematic analysis
Vision Res
(1992) - et al.
Binocular cues are important in controlling grasp but not the reach in natural prehension movements
Neuropsychologia
(2000) - et al.
Laparoscopic and open cholecystectomy. A prospective, randomized study
Eur J Surg
(1993) - et al.
An ergonomic analysis of the fulcrum effect in the acquisition of endoscopic skills
Endoscopy
(1998) - et al.
Experienced laparoscopic surgeons are automated to the “Fulcrum effect”An ergonomic demonstration
Endoscopy
(1999) - et al.
The role of learned pictoral cues in the programming and control of grasping
Exp Brain Res
(1998)
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