Page 23 - World Journal of Laparoscopic Surgery

WJOLS
WJOLS

10.5005/jp-journals-10033-1240
Effect of Warm-up Exercises on Laparoscopic Trainer: Improvement of Operator Smoothness
RandOmized cOntROL tRiaL

Effect of Warm-up Exercises on Laparoscopic Trainer:

Improvement of Operator Smoothness

2
1 Nava Navaneethan, Peter Hewett

ABSTRACT warm-up often consists of both mental and physical
Background: Several recent studies have produced conflicting exercises. Studies have demonstrated that mental practice
results of warming up prior to laparoscopic surgery and surgi- can significantly improve performance among not only in
cal performance. The purpose of this study was to investigate athletes but also in surgeons as well. Conflicting results
whether warming up prior to a laparoscopic task improves a 1
subsequent task performed on a laparoscopic trainer. are found among studies, with some smaller studies
Materials and methods: A prospective randomized controlled showing improvement in subsequent performance and
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trial was conducted to compare warm-up modalities to no no improvement in another study. Aim of this study is to
warm-up. The study was conducted at a single site, with 44 analyze surgeon’s performance in performing designated
participants, including surgeons, medical students and surgical tasks in laparoscopic trainers with and without warm-up
trainees. Randomization done within each group.
Control group was asked to do a designated task without exercises, using multiple metrics analysis of performance
a warm-up. Warm-up groups were asked to perform a warm- including the speed. It is expected that warming up on
up exercise prior to the designated task. Performances were a similar situation not only improves the speed but also
recorded and analyzed with a computerized software different
performance parameters were compared. helps the brain to adopt a 2 D perception quicker.
Results: Warm-up was a significant predictor of smoothness A similar study performed to compare the effects
of the operator’s hand movement at the 5% significance level of warming up found no effect but the warming up
(p = 0.0358). exercises were not similar to actual surgical procedure
While there were some improvement of performances
between control groups was demonstrated, they were not in this study and analysis of surgical performance was
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clinically significant. subjective of investigator bias. By using a computerized
Conclusion: This study shows that warming up prior to a task performance analysis the subjective investigator bias
has a positive influence in the subsequent performance in is eliminated.
smoothness of instrument movement in surgeons group. The
major limitation of the study was the number of participants.
Keywords: Exercises, Laparoscopy, Simulation, Training, mATERIALS ANd mETHOdS
Warm-up. Surgeons, surgical trainees and medical students (total of
How to cite this article: Navaneethan N, Hewett P. Effect of 44) are randomized for control or post warm-up groups
Warm-up Exercises on Laparoscopic Trainer: Improvement of
Operator Smoothness. World J Lap Surg 2015;8(1):21-25. and tested for their speed and 3 other performance
Source of support: Nil metrics.
Participants were given written explanation and writ-
Conflict of interest: None
ten consent is obtained. An ethical approval was obtained
for the study.
INTROduCTION
Control participants are tested for their speed and
Preperformance practice is standard in many nonsurgical performance of a specific task A on a laparoscopic trainer.
fields. Warming up is ubiquitous among athletes, musi- Post warm-up group had warming up task B on a
cians, artists and military personnel. Preperformance laparoscopic trainer for 10 minutes followed by the same
specific task A.
(Task A threading through pegs)
1 Director, Professor (Task B applying paper clip chain on pegs).
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1 Department of Obstetrics and Gynecology, Griffith Base The procedure was recorded and performances were

Hospital, NSW, Australia analyzed with InSTrAC software program.

2 Department of Head Colorectal Surgery, Queen Elizabeth Outcome measures checked.
Hospital, Adelaide, SA, Australia Following metrics were measured:
Corresponding Author: Nava Navaneethan, Director 1. Average speed/time taken to complete the task
Department of Obstetrics and Gynecology, Griffith Base 2. Acceleration
Hospital, Griffith NSW 2680, Australia, Phone: 0269695555 3. Smoothness
e-mail: snava5@hotmail.com
4. Working area.
World Journal of Laparoscopic Surgery, January-April 2015;8(1):21-25 21