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The "Peg Transfer" Task is similar to the Task 1 of the FLS course (Fundamentals of Laparoscopic Surgery)*. Need to transfer back and forth 6 prisms with both instruments alternately.
- Coordinate movements of the both instruments.
- Usage of the designated rotation wheel for instrument rotation.
- Visual-spatial orientation based on “flat” 2D-picture – confident determination of object position and distance to it, precise movement of the scope to the desired location.
- Learn "fulcrum effect" (lever effect), gain its control and compensation.
- Keep ergonomic body and hands position during the endosurgical procedure.
Equipment: Two Maryland dissectors, one Platform with 12 pegs, 6 colour rubber prisms.
Setup: Place the platform with pegs on the lower velcro stripes of the trainer. Adjust the camera so platform to middle of the screen and back opening is not visible. All six coloured prisms can be randomly aligned on the pegs on the side of user’s non-dominant hand.
Aim: coloured object (prism) have to be picked up, transferred to the other instrument and placed on peg at the opposite side. As soon as all six prisms are transfered repeat it backwards.
Performance: grasp the prism with dissector in non-dominant hand, transfer the object mid-air to the dissector in dominant hand and then place it on any peg on the opposite side of the pegboard. Color and peg sequence are not important. Each transfer must be mid-air without using the board or pegs for assistance. Once all six objects have been transferred to the opposite side of the board, reverse the process and first grasp each object with your dominant hand, transfer mid-air to your non-dominant hand, and place it on the original side of the platform.
Proficiency: according to the principles of the proficiency-based training the task should be practiced until it can be performed in proficiency time (112 sec) or less; this level should be demonstrated consecutively twice. If a trainee cannot achieve this level of performance after 80 repetitions of the task, that trainee should proceed to the next task.
Start: Touch the first object.
Finish: Release of the last object.
- Time limit (sec): 300
- Target time (sec): 112
- Passing score: 100
- Path: left and right instruments
- Ambidexterity, %: 40-60
- Speed: overage left and right; maximal left and right instruments
Errors, Penalties and Failures
Error: prism is dropped. In this case the prism pick up the prism with the hand it was dropped with and continue the task. There is no penalty for dropping the object within the field of view. If prism is dropped outside of the field of view or cannot be retrieved due to length of instrument, the task is continued with the remaining objects. For each prism dropped away in the first part of the task penalty is 20 points, in the second part – 10 points.
Fails (task aborted):
- the task is aborted when the task rules are violated, e.g. start with wrong instrument;
- no change of instruments;
- the drop is used as the transfer point, etc.
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Time limit (sec): 600 Time target (sec): 112 Number of points: 100 Ambidexterity, %: 50 Evaluated parameters: Proper hands, droped triangles, all triangles moved forth and back. Formula: Formula Score = 212 – t – 20*(p1) – 10*(p2), where t – is fulfilment time, p1 – number of dropped away prisms at the first part of the task, p2 – number of prisms dropped away at the second part of the task.
Compare with you:
X Date Attempt
Path, mm Av.Speed, mm/sec Max.Speed, mm/sec
Target values: 100 112 - 50 - - - - - -