The experimental evaluation of the effects of display size on forceps manipulation and eye and head movement of endoscopic surgery using a pediatric laparoscopic fundoplication simulator

The size of the display used for endoscopic surgery has been increasing recently, but the effect of the display size on procedure outcomes is unclear. The present study clarified the effect of display size on the outcomes of endoscopic surgical procedures. Eight pediatric surgeons performed the laparoscopic fundoplication task using a disease-specific laparoscopic simulator with 3 different display sizes (43, 32, and 24 inches). The movement of the forceps during the task was measured using an electromagnetic spatial three-dimensional position-measuring instrument. The movements of the eyes and head during the task were also measured using glasses-style smart eyewear. We assessed the time required to complete the task, total path length of forceps, average velocity of forceps, number of blinks, number and strength of eye movements, and head tilt of participants during the task. There were no significant differences in the required time, total path length, average velocity, number of blinks, number and strength of eye movements, or head tilt among the three display sizes. After the task, participants were asked which display felt the easiest to use. Four participants (50%) answered that the 32-inch display was easiest to use. This study showed that display size differences did not influence endoscopic surgical procedures. However, 50% of participants felt that the task was easiest using the middle display size. There may be an optimal monitor size for a given procedure. Level II.