The effect of image orientation on a dynamic laparoscopic task

During laparoscopic surgery, the surgeon's hand-eye coordination is often disrupted by the incongruent mapping between the orientation of the endoscopic view and the actual operative field. This can lead to higher mental load and deteriorated performance for the surgeon. This study investigated the effect of visual-motor misalignment on laparoscopic surgery performance. Twenty-four subjects participated in a dynamic point-and-touch task, with 8 image rotations under different optical axes and different endoscope locations in a simulated laparoscopic surgery environment. Performance was best when the endoscopic image was perfectly aligned with the actual task space (0° image rotation), but degraded progressively as a function of deviation from perfect alignment. Subjects' performance maintained a consistent pattern across 8 image rotations regardless of optical axis orientation and endoscope location. Therefore, it is recommended that any solution to restore the visuomotor congruency in laparoscopic surgery should first align the image with the task space.