Randomly alternating image presentation during laparoscopic training leadsto faster automation to the "fulcrum effect"

Background and Study Aims: The aim of this study was to evaluate four train ing programmes intended to help laparoscopic surgeons automate to the "fulc rum effect". Methods: A total of 32 participants (16 men, 16 women), were randomly assig ned to one of four different image-viewing conditions: full binocular, y-ax is inverted, normal laparoscopic and randomly alternating (between axis-inv erted and normal laparoscopic). The subjects were requested to perform 10 t rials of a simple laparoscopic cutting task, each lasting 2 minutes. Each t hen completed a 2-minute test under normal laparoscopic imaging conditions. Results: In the final test trial, participants who trained under the random ly alternating imaging conditions (y-axis inverted and normal laparoscopic) performed significantly better than those from the other groups. Conclusion: Training under a randomly alternating viewing condition helps l aparoscopic trainees automate to the "fulcrum effect" faster.