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Biomedical subjects

A G Gallagher

Publications and source records attributed to A G Gallagher.

25 records · Page 2Linked to original sources

Virtual reality training in laparoscopic surgery: a preliminary assessment of minimally invasive surgical trainer virtual reality (MIST VR).

BACKGROUND: The "fulcrum effect" of the body wall on surgical instrument manipulation is a major hurdle for novice endoscopic surgeons. Virtual reality training has not previously been evaluated as a means to overcome this problem. MATERIALS AND METHODS: 16 participants with no experience of endoscopy were required to make multiple defined incisions under laparoscopic laboratory conditions within 2-minute periods. Half of the subjects were randomized to receive initial training on the Minimally Invasive Surgical Trainer, Virtual Reality (MIST VR) computer programme. RESULTS: Participants with MIST VR training made significantly more correct incisions (P = 0.0001) than the control group on test trial 1, and even after extended practice by both groups (P = 0.0001). They were also significantly more likely to actively use both hands to perform the endoscopic evaluation task (P = 0.01). CONCLUSIONS: Virtual reality training represents a potential, viable solution for junior endoscopists, for overcoming the "fulcrum effect", in a replicable, safe learning environment which allows objective and reliable quantification of skill levels by trainers.

Adult↗

Experienced laparoscopic surgeons are automated to the "fulcrum effect": an ergonomic demonstration.

BACKGROUND AND STUDY AIMS: The inversion of the normal laparoscopic image around the Y-axis has been shown to facilitate the rate of learning of a laparoscopic task in novice subjects. The aim of this study was to investigate the effect of Y-axis image inversion on the performance of experienced laparoscopic surgeons; this had not been previously investigated. METHODS: A total of 16 experienced surgeons,who had already carried out more than 50 operative laparoscopic procedures, and 16 novice participants, who had carried out no procedures, were required to make multiple defined incisions under laparoscopic laboratory conditions within ten 1-minute periods. Participants were randomly allocated to perform the task under either normal or Y-axis inverted imaging conditions (eight experienced surgeons and eight novices in each condition). RESULTS: Y-axis inversion had a significant detrimental effect on the performance of the surgeons, whilst facilitating the performance of novices. The surgeons however, adapted to the inverted condition rapidly, showing a significant improvement in performance over the ten trials. CONCLUSIONS: The Y-axis-inverted image has a detrimental effect on the performance of experienced surgeons, indicating that they have automated to the "fulcrum effect" of the abdominal wall on instrument manipulation. Y-axis-image inversion was found to facilitate significant learning trends, regardless of the participants' level of experience.

Abdomen↗

An ergonomic analysis of the fulcrum effect in the acquisition of endoscopic skills.

BACKGROUND: The loss of three-dimensional visual depth cues has been thought to be the main hindrance to the acquisition of endoscopic skills. However, the "fulcrum effect" of the abdominal wall on the manipulation of instruments has not to our knowledge been previously investigated. METHODS: Subjects with no experience in endoscopy were required to make multiple defined incisions under laparoscopic laboratory conditions, within ten two-minute periods in the first study and 50 in the second. Eleven subjects operated under normal imaging conditions and 11 with the y-axis inverted. RESULTS: Subjects who operated with the image inverted made significantly more incisions and significantly more correct incisions than those working under normal conditions. This effect persisted over 50 trials. CONCLUSIONS: The fulcrum effect has a major detrimental influence on acquisition of endoscopic skills. Further work is required to investigate the role of image inversion in clinical endoscopic training.

Adult↗

The effects of varying information content and speaking aloud on auditory hallucinations.

The aim of this study was to investigate why requiring hallucinating schizophrenic subjects to read aloud produces large reductions in reports of auditory hallucinations. In Expt 1 hallucinating subjects (N = 9) were required to sort cards quietly into one, two, four, 13 and 26 piles. It was shown that the large reductions in the reports of hallucinations produced by reading aloud could not be accounted for in terms of the information content of the task. In Expt 2 the subjects (N = 7) were required to place the cards into one or two piles quietly or whilst saying the colour of the card aloud. Sorting cards into two piles whilst saying the colour of the card produced the largest reductions in the reports of hallucinations. It was concluded that it was the requirement to make overt motor and verbal response that produced the large reductions in reports of auditory hallucinations in the reading-aloud task.

Adult↗

The effects of varying auditory input on schizophrenic hallucinations: a replication.

The aim of this study was to investigate the effects of different types of auditory stimulation on reports of auditory hallucinations at the time of the experiment. The results showed that self-reports by seven schizophrenic patients of auditory hallucinations were reduced by different types of auditory stimulation, particularly by listening to pop music. Requiring the subject to read a passage aloud also reduced the levels reported. This study was a replication of one by Margo, Hemsley & Slade (1981) who reported similar findings.

Acoustic Stimulation↗