This has been quantified by this group of researchers who evaluated the optimal placement of the laparoscope positioning between the two working trocars with regards to surgeon performance and correlated this with surgical experience. They had three groups of surgeons including group 1 with no surgical experience, group 2 with moderate laparoscopic experience (1-100 cases), and group 3 which was laparoscopically experienced (greater than 100 cases).

The participants were timed in performing a simple laparoscopic task three times in a pelvic trainer with the laparoscopic camera angles randomized along the horizontal plane between 0o, 45o, 90o, 135o, and 180o. All of the participants showed progressive deterioration in performance as the angle deviated from the baseline of 0o. Performance curves for each of the surgeon groups revealed more pronounced deterioration of performance, with alteration in the angle of vision, in the no-surgical experienced group compared to those participants who had moderate or extensive experience with laparoscopy. Even a modest alteration in the laparoscopic perspective results in deterioration of performance for all levels of surgical experienced and this highlights the importance of taking the time to appropriately position the laparoscope and working on instruments.

An intuitive surgical perspective includes a port placement that allows the eyes (i.e. laparoscope) to be positioned directly between the two "hands" (i.e. the working instruments). This is particularly critical for surgeons early in their laparoscopic experience.

Journal of Endourology 20:281-283, 2006