Virtual Reality (VR) Technology in Laparoscopy Surgery: The Effect of Large Viewing Angle from the Head-Mounted Display (HMD) and Laparoscopic Performance

Background: A vital component of laparoscopic surgery is its display monitor. The viewing angle of the laparoscopic monitor impacts on the performance of the surgeon. Given that head-mounted display (HMD), an integral part of Virtual Reality (VR) technology, offers a large viewing angle, this project aimed to determine the potential benefits of using HMD in performing laparoscopic tasks. Methods: 54 laparoscopic/endoscopic clinicians performed a simulated laparoscopic task with three different monitors (HMD, 21-inch and 15-inch monitor) in a random order. Duration of task, distance travelled by graspers and manipulation errors were recorded and analyzed. Simulation Sickness Questionnaires (SSQs) were also given to participants. Results: There were statistically significant differences in all performance metrics recorded across all groups when compared to each other (P<0.05). HMD had the longest task completion duration followed by 15-inch and 21-inch monitors. However, the distance travelled by the graspers and error rate was lowest in the HMD group followed by 21-inch and 15-inch monitors. The SSQ questionnaire showed that eye strain and headache are the two most common transient side effects recorded by users of HMD. Conclusion: The study shows that HMD users perform fewer mistakes and are more precise with the movement of graspers compared to other groups. As such, HMD has the potential to enhance laparoscopic performance. HMD is cost effective and has the added benefit of improving surgical ergonomics. Further research should focus on ensuring that HMD is a viable and safe alternative to conventional laparoscopic monitor as well as in identifying barriers to adoption.