Replicating Visuo-Motor Remapping in the Laparoscopic Environment

Laparoscopy, a minimally invasive surgical technique, requires precise visuo-motor coordination. Because the surgical field is viewed through a camera which may need to be placed to one side of the would-be direct line of sight, rotational distortion is a concern. This study investigates adaptation to rotational distortions by replicating previous computerized two-dimensional perceptual-motor experiments, and measurement methods, using a non-virtual low-fidelity laparoscopic training simulator. This replication was chosen for the opportunity to observe the best-established adaptation mechanisms (gradual and axis-inversion) and carryover effects. To our knowledge, this is the first time that circular statistics are used to analyze directional error data collected in the laparoscopic environment. Results strongly indicated that gradual adaptation occurs with distortions below 90°, and there is leading evidence that axis-inversion occurs in distortions above 90°. This confirms previous observations of task performance decrement in the laparoscopic environment and provides clarification for new research directions.