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Impact of accommodation, convergence and stereoacuity on perceived symptoms and surgical performance among surgeons

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Abstract

Background

Minimally invasive surgery (MIS) is not without impact on surgeons’ neck/shoulder/head and eyes. However, the mechanisms for concurrent symptoms are not clear. This study aims to examine the effect of visual impairments on physical symptoms and surgical performance among surgeons performing simulated surgical tasks using two-dimensional (2D) and three-dimensional (3D) viewing modes.

Methods

Gynaecologists with experience in laparoscopy performed four simulated surgical tasks in the 2D and 3D viewing modes. Visual parameters (accommodation, convergence and stereoacuity) were measured prior to commencement. Objective performance measures were derived from the laparoscopic tasks, and surgeons also self-reported their mental and physical workload using the NASA-TLX. In addition, perceived symptoms were measured using Visual Analogue Scales, the Simulator Sickness Questionnaire and the Computer Vision Syndrome Questionnaire.

Results

Seventeen healthy gynaecologists participated in this study. There were significant relationships between visual impairments and both the perceived symptoms and surgical performance scores of MIS surgeons. Surgeons with a higher number of accommodation/convergence dysfunctions and/or poorer stereoacuity tended to have poorer objective performance scores on simulated surgical tasks in both viewing modes. NASA-TLX scores indicated that surgeons with poorer stereoacuity also perceived themselves to have been less successful at accomplishing tasks. However, these surgeons also reported less intense physical symptoms and simulator sickness.

Conclusions

Surgeons’ performance for the simulated surgical tasks correlated with visual functions, and it also impacted on the symptoms experienced. Regular screening of surgeons’ vision and vision therapy may be required to decrease physical symptoms and improve surgical performance.

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Acknowledgements

The first author is a recipient of the University of Queensland, Research Scholarship (UQRS), Australia.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. School of Health and Rehabilitation Sciences, The University of Queensland, Level 3, Therapies Annexe Building 84, St Lucia, Brisbane, QLD, 4068, Australia

    Ameer Alhusuny & Julia Treleaven

  2. School of Earth and Environmental Sciences, Faculty of Science, The University of Queensland, Brisbane, Australia

    Margaret Cook

  3. Faculty of Medicine, The University of Queensland, Brisbane, Australia

    Akram Khalil

  4. Royal Brisbane and Women’s Hospital, Brisbane, Australia

    Akram Khalil

  5. Clinical Skills Development Service, Metro North Hospital and Health Service, Brisbane, Australia

    Andrew Hill

  6. Minerals Industry Safety & Health Centre, Sustainable Minerals Institute, The University of Queensland, Brisbane, Australia

    Andrew Hill

  7. School of Psychology, The University of Queensland, Brisbane, Australia

    Andrew Hill

  8. RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia

    Venerina Johnston

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  1. Ameer Alhusuny
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Contributions

AA, MC, AK, and VJ did the study conception and design. AA, MC, AK, JT, and VJ carried out acquisition of data. Analysis and interpretation of data have been done by AA, MC, JT, AH, and VJ. All authors were involved in drafting the article, revising it critically for important intellectual content, and have given final approval of the version to be published.

Corresponding author

Correspondence to Ameer Alhusuny.

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Disclosures

Drs. Ameer Alhusuny, Margaret Cook, Akram Khalil, Julia Treleaven, Andrew Hill and Venerina Johnston have no conflicts of interest or financial ties to disclose.

Ethical approval

This research was approved by the Metro North Hospital and Health Service Human Research Ethics Committee (HREC/18/QRBW/252) and The University of Queensland’s Human Research Ethics Committee (#2018001518) Brisbane, Australia.

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Alhusuny, A., Cook, M., Khalil, A. et al. Impact of accommodation, convergence and stereoacuity on perceived symptoms and surgical performance among surgeons. Surg Endosc 35, 6660–6670 (2021). https://doi.org/10.1007/s00464-020-08167-2

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