Assessment of Performance Carryover Effects Due to Successive Exposure to Different Lateral Camera Rotations in a Laparoscopic Training Environment

Objective: The aim of this study was to assess performance carryover effects associated with different successive lateral camera rotations in the laparoscopic training environment. Background: Laparoscopy requires surgeons to adapt to disruptions of visuomotor mapping. A gradual adaptation process is hypothesized to be effective up to a given rotation threshold; this threshold may have performance implications for successive exposure to different lateral camera rotations. Method: Two experiments utilized a laparoscopic training task. Experiment 1 exposed novices to a subsequent rotation that was either 45° larger than one of the initial rotations of 45°, 75°, 105°, and 135° or 45° smaller than one of the initial rotations of 90°, 120°, 150°, and 180°. Experiment 2 exposed novices to either stepwise increasing rotations (0° to 180°) or stepwise decreasing rotations (180° to 0°). Results: Regarding Experiment 1, performance generally improved for subsequent rotations that were 45° larger than the initial rotation, except for one condition (initial rotation, 105°; subsequent rotation, 150°). Performance generally improved for subsequent rotations that were 45° smaller than the initial rotation, except for one condition (initial rotation, 120°; subsequent rotation, 75°). Experiment 2 indicated worst performance at 120° for the increasing and decreasing conditions. This finding suggests an identical threshold for increasing and decreasing rotations, which is inconsistent with Experiment 1 results. Conclusion: Improved performance due to carryover effects from successive exposure to lateral camera rotations in the laparoscopic training environment is contingent on the specific camera rotations. Application: Supplementary laparoscopic training might be needed for surgeries that entail certain successive lateral camera rotations.