title: Video-assisted surgery represents more than a loss of three-dimensional vision.
abstract: BACKGROUND
  Loss of depth cues is a major challenge facing surgeons performing video-assisted surgery (VAS). Whether the degradation of image quality from a video-displayed image plays a direct role in performance of VAS has not been studied.
  
  
  METHODS
  Twenty-four volunteer novice subjects were randomized to binocular direct-vision (BDV), monocular direct-vision (MDV), or video-imaging (VI) conditions. Each subject completed ten trials of a simple cutting task in a box trainer using standard laparoscopic instruments.
  
  
  RESULTS
  VI subjects made significantly fewer correct incisions than both of the other groups for all trials. Differences between the BDV and MDV groups did not reach statistical significance. Improvement in performance was more rapid in the BDV group than in either the MDV or VI groups.
  
  
  CONCLUSIONS
  The degradation of image quality with VI has a detrimental influence on VAS performance above and beyond the loss of binocular vision.
authors.affiliation: Emory Endosurgery Unit, Department of Surgery, H-124, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322, USA.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Gallagher
authors.forename: E Matt
authors.initials: EM
authors.lastname: Ritter
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Lederman
authors.forename: David A
authors.initials: DA
authors.lastname: McClusky
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Smith
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003463:Cues; D003867:Depth Perception; D005260:Female; D006801:Humans; D008297:Male; D013647:Task Performance and Analysis; D020535:Video-Assisted Surgery