Keep it simple: a crosshair on the screen during proctored laparoscopic surgeries

Abstract

Abstract Introduction Inside the operating room, experts use verbal instructions to guide surgical novices through laparoscopic procedures. In this study, we evaluated the use of a crosshair attached to the video monitor, as a hands-free pointing tool to simplify instructions during operation. Methods Ten surgical novices performed two elective laparoscopic cholecystectomies within a week of each other, randomized such that one was performed with and the other without using the crosshair. Directly after operation, questionnaires were completed by the novices and the consultant surgeons. Measures including the comprehensibility of instructions, subjective feeling of safety during preparation, time delays due to different instruction options, and disruptive influence while instructors used the crosshair. Differences in operative performance were evaluated based on GOALS scores. Results When the crosshair was used, surgical novices had a better understanding of which anatomical structure should be shown (p < 0.02). Operating time and feeling of confidence during preparation did not differ with versus without crosshair use (p > 0.05). All participants stated that the crosshair did not negatively affect the field of vision. In terms of the GOALS score, the operative performance was improved when the crosshair was used (15.0 ± using crosshair vs. 12.4 ± with verbal instructions only) (p < 0.01). Conclusion The crosshair is a simple, inexpensive, and widely available method to improve communication between instructors and novices in everyday training.