Understanding the Effect of Passive View on Surgical Performance in Simulation-Based Endoscopic Surgery Education

Abstract

With the improvements of technologies in the field of surgery, minimally invasive surgical (MIS) technique have become the standard of surgical care for many patients which is performed through the camera view of the operational area from small entry points to the patients' body. Unlike open surgery, MIS is, by its nature, a technique that is very suitable for simulation based training. Developing special skills by using surgical simulations before entering an operating room enables more focused and efficient performance, which minimizes time in the operating room and enhances patient safety. Beside the benefits, MIS reveals some drawbacks as well, such as passive view. Passive view occurs when the surgeon needs the help of assistant to control the camera instead of controlling by his own movements. In such cases, performing the operation from the assistant's camera controlled view is considered as passive view. Earlier studies show that this passive view problem affects the surgical performance. Accordingly, the related surgery training programs should consider providing skills on passive view and the surgical tool designers also should consider this problem in their designs. Hence understanding the concept of passive view in general and understanding its possible affects on surgical performance is critical to improve the surgery process. Additionally, understanding the instructional considerations to better provide environments to practice for gaining these skills are critical for the domain of endoscopic surgery education programs. However, in the literature there are not many studies related with the passive view problem in endoscopic surgery procedures. In this study, a literature review is conducted to better understand the problems related with the passive view. Additionally, a pilot experimental study is conducted through a surgical simulation environment. The results of this study aimed to provide guidelines to the surgical training programs and the instructional system designers to improve the skills of the trainees to better deal with passive-view problem in endoscopic surgery.