Abstract
Introduction:
Research in sport has shown that gaze training interventions can enhance the development of motor skills. There has been little research into the strategic gaze behaviours adopted by surgeons. Virtual reality (VR) surgical simulators provide repetitive practice and performance feedback without requiring supervision in a safe environment. By understanding the psychomotor processes underpinning expertise, proficiency-related training interventions can be developed. The aim of this study was to identify any differences in gaze control parameters between experts and novices whilst performing VR endoscopic surgery.
Method:
11 experts (>50 TURPs performed) and 16 novices (<50 TURPs performed) completed a VR median lobe resection (Simbionix™ TURPSim™) whilst wearing an eye tracker. Several parameters were measured and compared between the two groups: task performance (percentage of prostate resected per second); task safety (total time in seconds the diathermy was active without tissue contact); visual control strategy employed (number of visual fixations/average duration of visual fixations).
Results:
Experts resected a greater percentage of prostate per second than novices (t-test 0.79 vs 0.50, p < 0.05) and had less active diathermy time without tissue contact (t-test 0.91 vs 2.88, p < 0.05). Experts visual control strategy employed fewer but comparatively longer visual fixations (t-test 474.52 vs 172.01, p < 0.01).
Conclusions:
Significant differences between experts and novices in all measured parameters were observed. Further work is required to identify if the visual strategies adopted by experts are replicated during real-life resections. Ultimately we hope to develop a VR TURP training programme reflecting real-life expert visuomotor control strategies.