A training tool to assess laparoscopic image navigation task performance in novice camera assistants

Mahbub Alam, Michael S. J. Wilson (Lead / Corresponding author), Benjie Tang, Iain S. Tait, Afshin Alijani

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
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Background: A number of tools for assessing task performance of the laparoscopic have been described, but few focus on the acquisition and assessment of the attainment
of proficiency in novice laparoscopic camera assistants. Our aim was to develop a simulated objective assessment tool for a novice camera assistant.

Materials & Methods: A 10-cycle image navigation task tool was developed. This involved a series of 360 degree clockwise and anti-clockwise rotation manoeuvres of a
30 degree laparoscope along its shaft, focusing on a predefined geometric target on a 45 degree fixed slope in a laparoscopic box trainer. The tasks were to simultaneously
maintain neutral horizon, optimum distance and centring. Task accuracy and time to completion were assessed objectively at 3-second intervals on an unedited video

Results: 29 novice medical students were assessed. Novices improved mean total error and task completion time (1st vs. 5th cycle, mean errors 15.4 vs. 8.4, p=0.048; mean task time 158.1 vs. 92.9 seconds, p=0.04). This improvement continued until the task cycle was completed (6th vs. 10th cycles, 7.9 vs. 6.2, p=0.01; 91.9 vs. 76.6 seconds, p<0.0001). There was a significant decrease in centring errors (5.2 vs. 2.4, p=0.001) and horizon (4.8 vs. 2.3, p=0.004), when comparing the 1st versus 5th task cycle. It took 6 cycles for optimum distance to achieve significance (5.4 vs. 3.3, p=0.023).

Conclusions: Using our assessment tool, novices achieved an objective proficiency-gain curve for laparoscopic camera navigation tasks. There was improvement in errors
related to maintaining horizon, optimum distance and centring. Mean task completion time also decreased. This tool could be used as an additional means of assessment and
training in novice surgical trainees.
Original languageEnglish
Pages (from-to)232-237
Number of pages6
JournalJournal of Surgical Research
Early online date1 Jul 2017
Publication statusPublished - Nov 2017


  • proficiency-gain curve
  • surgery
  • laparoscopy
  • training
  • simulator
  • camera assistant
  • surgical education


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