Concentration Area: Medical Technology and Innovation
- Authors: Christopher J. Prendergast, BS, Beth A. Ryder, MD, Adam Abodeely, MD, Christopher S. Muratore, MD, Gregory P. Crawford, PhD, and Francois I. Luks, MD, PhD
- Abstract: Introduction: The difficulties of laparoscopic surgery include two-dimensional image projection and loss of
alignment between the surgeon’s hands and visual field. Head-mounted displays (HMDs) allow freedom from
gazing at a stationary overhead monitor, thus improving ergonomics. Modern HMDs offer greatly improved
image quality and reduced bulk and weight. We compared two types of HMDs with conventional overhead
Materials and Methods: Twelve preclinical medical students (i.e., laparoscopic novices) completed the standardized
bead-passing task in a Fundamentals of Laparoscopic Surgery box trainer, using a wall-mounted monitor
(WALL), a solid-state high-resolution dual full-visual graphic array (VGA) HMD (HIGH-HMD), or a lightweight
commercial 1/4 VGA HMD (LOW-HMD). Participants performed each task by using the three image
displays. The order in which they performed each test was randomly assigned to minimize the carryover effect.
Students were then asked to grade comfort and image quality on a scale from 1 (worst) to 5 (best). Statistical
comparison of the time per bead was performed with the Kruskal-Wallis test, and P 0.05 was considered
Results: Average time per bead (total beads 12/participant/test) was 14.2 seconds for WALL, 13.2 seconds
for LOW-HMD, and 12.5 seconds for HIGH-HMD (P 0.05). The comfort ratings were 3.67 0.82, 3.50 1.38,
and 3.83 0.75, respectively, and image quality was rated as 3.00 0.63, 2.83 1.47 and 4.67 0.52, respectively.
Conclusions: The high-resolution HMD offered significantly better image quality and allowed faster task performance
than a lower resolution model of HMD, and both performed better than the overhead display. The
high-resolution HMD was not significantly more comfortable than the low-resolution model, given its added
weight. HMDs alone may only be of incremental benefit in improving performance in laparoscopic surgery.
However, their greatest promise is in their combination with other advances in imaging and image manipulation
technology, as they open the door to individualized image display.
- Journal: JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES
- Volume: 19(S1)
- Pages: s.237-s.240
- Year: 2009
- Publisher: Mary Ann Liebert, Inc.