Impact of three-dimensional vision in laparoscopic training.
BACKGROUND
Simulators are being used to teach laparoscopic skills before residents get to the operating room. It is unknown whether the use of three-dimensional (3D) vision will facilitate laparoscopic training. Therefore, our objective was to compare the effectiveness of using 3D imaging over the traditional two-dimensional (2D) imaging to teach laparoscopic simulator skills to novice individuals and assess whether 3D imaging ameliorates laparoscopic performance for surgeons who have already adapted to working within a 2D surgical environment.


METHODS
This prospective study involved 36 surgical residents and students. Inexperienced participants included medical students and first- and second-year surgical residents (n = 25). Experienced participants included third- and fifth-year surgical residents (n = 11). Participants were tested on six laparoscopic skills using 2D or 3D imaging systems and then retested about 3 months later using the opposing imaging system. Evaluation of performance was based on the time elapsed to task completion and the errors committed during that time.


RESULTS
The experienced participants performed better than the inexperienced participants regardless of the imaging system. Inexperienced participants initially tested using 2D imaging required significantly more time and/or made more errors to complete five of the six laparoscopic tasks compared to those initially tested using 3D imaging (p < 0.05). After initial testing on 3D imaging, inexperienced participants retested using 2D imaging performed significantly better on five of six tasks compared to the scores of inexperienced participants initially tested on 2D imaging (p < 0.05). In contrast, the inexperienced participants' retested on 3D after initial 2D imaging did not improve on any laparoscopic task compared to the scores of inexperienced participants initially tested on 3D imaging. Among the experienced participants, no significant difference in time or errors to task completion was observed under 2D imaging compared to 3D imaging during the first or second testing session.


CONCLUSIONS
Our study indicates that 3D imaging offers significant advantages in the teaching of laparoscopic skills to inexperienced individuals.
Votanopoulos
Konstantinos
K
Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030, USA.
Brunicardi
F Charles
FC
Thornby
John
J
Bellows
Charles F
CF
D000328:Adult; D000704:Analysis of Variance; D003198:Computer Simulation; D018592:Cross-Over Studies; D004503:Education, Medical, Graduate / Q000379:methods; D004504:Education, Medical, Undergraduate / Q000379:methods; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000592:standards*; D008297:Male; D011446:Prospective Studies; D011597:Psychomotor Performance