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The research catalogue is an archive of ESRC-funded grants and outputs. Links, files and other content will no longer be maintained or updated after April 2014.

'Bilateral (Hong Kong):' Gaze strategies of laparoscopy surgeons: Observational learning, implicit knowledge and performance in demanding conditions

Grant reference: RES-000-22-3016

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Journal article details

Perceptual impairment and psychomotor control in virtual laparoscopic surgery
It is recognised that one of the major difficulties in performing laparoscopic surgery is the translation of two-dimensional video image information to a three-dimensional working area. However, research has tended to ignore the gaze and eye-hand coordination strategies employed by laparoscopic surgeons as they attempt to overcome these perceptual constraints. This study sought to examine if measures related to tool movements, gaze strategy, and eye-hand coordination differentiate between experienced and novice operators performing a two-handed manoeuvres task on a virtual reality laparoscopic surgical simulator. Twenty-five right-handed surgeons were categorised as being either experienced (having led more than 60 laparoscopic procedures) or novice (having performed fewer than 10 procedures) operators. The 10 experienced and 15 novice surgeons completed the “two-hand manoeuvres” task from the LAP Mentor basic skills learning environment while wearing a gaze registration system. Performance, movement, gaze, and eye-hand coordination parameters were recorded and compared between groups. The experienced surgeons completed the task significantly more quickly than the novices, used significantly fewer movements, and displayed shorter tool paths. Gaze analyses revealed that experienced surgeons spent significantly more time fixating the target locations than novices, who split their time between focusing on the targets and tracking the tools. A more detailed analysis of a difficult subcomponent of the task revealed that experienced operators used a significantly longer aiming fixation (the quiet eye period) to guide precision grasping movements and hence needed fewer grasp attempts. The findings of the study provide further support for the utility of examining strategic gaze behaviour and eye-hand coordination measures to help further our understanding of how experienced surgeons attempt to overcome the perceptual difficulties inherent in the laparoscopic environment.

Primary contributor

Author Mark Wilson

Additional contributors

Co-author John S. McGrath
Co-author Samuel J. Vine
Co-author James Brewer
Co-author David Defriend
Co-author Richard S.W. Masters

Additional details

01 July 2011
New York, NY
Surgical endoscopy


Wilson_perceptual.pdf (.pdf / 490kb)

Cite this outcome


Wilson, Mark et al (2011) Perceptual impairment and psychomotor control in virtual laparoscopic surgery. Surgical endoscopy. 25 (7), pp. 2268-2274 New York, NY: Springer.


Wilson Mark et al. Perceptual impairment and psychomotor control in virtual laparoscopic surgery. Surgical endoscopy 2011; 25 (7): 2268-2274.