Postural control during laparoscopic surgical tasks.

BACKGROUND Balance control during standing is essential while performing surgery. The postural sway must be controlled to enhance movement accuracy. Postural control was compared between novices and experts during standardized laparoscopic tasks. METHODS Seven novices with limited exposition to laparoscopy were compared with 7 expert surgeons. The subjects were requested to perform 4 laproscopic tasks on the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) and a quiet standing task while standing on 2 force platforms. An analysis of variance (ANOVA) with repeated measures was performed to compare groups and the different conditions. Significant level was set at P < .05. RESULTS The technical requirements of the laparoscopic tasks impacted on postural sway in both anteroposterior and mediolateral directions. Furthermore, results indicate that the experts have a significantly better postural balance for all tasks compared to novices. CONCLUSION Postural sway increases with the technical requirements of minimally invasive surgery. This study showed that postural control performance while standing improves with laparoscopic expertise.

[1]  G. Fried,et al.  Development of a model for training and evaluation of laparoscopic skills. , 1998, American journal of surgery.

[2]  G. L. Pellecchia,et al.  Postural sway increases with attentional demands of concurrent cognitive task. , 2003, Gait & posture.

[3]  K. A. Ericsson,et al.  The Road To Excellence: The Acquisition of Expert Performance in the Arts and Sciences, Sports, and Games , 1996 .

[4]  A. Geurts,et al.  Dual-task assessment of reorganization of postural control in persons with lower limb amputation. , 1991, Archives of physical medicine and rehabilitation.

[5]  D. Rattner,et al.  The need for training opportunities in advanced laparoscopic surgery , 2001, Surgical Endoscopy.

[6]  Changes in postural mechanics associated with different types of minimally invasive surgical training exercises , 2003, Surgical Endoscopy And Other Interventional Techniques.

[7]  T. Grantcharov,et al.  Randomized clinical trial of virtual reality simulation for laparoscopic skills training , 2004, The British journal of surgery.

[8]  A. Park,et al.  Ongoing deficits in resident training for minimally invasive surgery , 2002, Journal of Gastrointestinal Surgery.

[9]  J. Lackner,et al.  Fingertip contact influences human postural control , 2007, Experimental Brain Research.

[10]  James R. Korndorffer,et al.  Simulator training for laparoscopic suturing using performance goals translates to the OR , 2004 .

[11]  Daniel B. Jones,et al.  Laparoscopic training on bench models: better and more cost effective than operating room experience? , 2000, Journal of the American College of Surgeons.

[12]  J. Raymakers,et al.  The assessment of body sway and the choice of the stability parameter(s). , 2005, Gait & posture.

[13]  F. Prince,et al.  Intrasession reliability of center of pressure measures of postural steadiness in healthy elderly people. , 2004, Archives of physical medicine and rehabilitation.

[14]  G. Fried,et al.  Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. , 2004, Surgery.

[15]  James R Korndorffer,et al.  Simulator training for laparoscopic suturing using performance goals translates to the operating room. , 2005, Journal of the American College of Surgeons.

[16]  D. Winter.  A.B.C. (anatomy, biomechanics and control) of balance during standing and walking , 1995 .

[17]  R. Fitzpatrick,et al.  Proprioceptive, visual and vestibular thresholds for the perception of sway during standing in humans. , 1994, The Journal of physiology.

[18]  J. Korndorffer,et al.  Development and transferability of a cost-effective laparoscopic camera navigation simulator , 2005, Surgical Endoscopy And Other Interventional Techniques.

[19]  G. Fried,et al.  Evaluating laparoscopic skills , 2003, Surgical Endoscopy And Other Interventional Techniques.

[20]  Geraldine L. Pellecchia,et al.  Dual-Task Training Reduces Impact of Cognitive Task on Postural Sway , 2005, Journal of motor behavior.

[21]  R. Satava,et al.  Virtual Reality Training Improves Operating Room Performance: Results of a Randomized, Double-Blinded Study , 2002, Annals of surgery.

[22]  Lucy Yardley,et al.  Does articulation contribute to modifications of postural control during dual-task paradigms? , 2003, Brain research. Cognitive brain research.

[23]  James R Korndorffer,et al.  Laparoscopic skills laboratories: current assessment and a call for resident training standards. , 2006, American journal of surgery.

[24]  G. Fried,et al.  Comparison of laparoscopic performance in vivo with performance measured in a laparoscopic simulator , 1999, Surgical Endoscopy.

[25]  J. Jeka,et al.  Light touch contact as a balance aid. , 1997, Physical therapy.

[26]  D. Gravel,et al.  Interaction between Attention Demanding Motor and Cognitive Tasks and Static Postural Stability , 2003, Gerontology.