title: Does 3-Dimensional (3-D) visualization improve the quality of assistance during robotic radical prostatectomy?
abstract: OBJECTIVE
  3-Dimensional (3-D) visualization by the surgeon is considered to be one of the major advantages of robotic prostatectomy. We undertook this study to see if passing on this technology to the surgical assistants would improve the efficiency of their assistance.
  
  
  METHODS
  The study was conducted in consecutive patients undergoing robotic radical prostatectomy by the same team, in one month at our center. A 3-D head mounted device (HMD) was used by the left and/or right assistant. Video recording from these patients were studied by a blinded observer with prior training in laparoscopic surgery for the efficiency of laparoscopic moves by the two assistants. These moves were scored on a point scoring system from 0 to 100 with 100 signifying the best possible performance.
  
  
  RESULTS
  After exclusions, 26 videos were available for review. Each patient had a right and left-sided assistant. The right-sided assistant had prior experience in Laparoscopic Urology, and the left-sided assistant had a relatively limited laparoscopic experience. The mean scores for the left assistant improved from 76.3 to 84.6 with the use of 3-D visualization (p < 0.002), while the improvement for the right assistant was from 84.1 to 86.9 (NS).
  
  
  CONCLUSIONS
  The use of 3-D visualization possibly improves the efficiency of assistance during robotic radical prostatectomies, for the assistant with limited experience in laparoscopic surgery. Because of the high-quality 3-D vision provided, these HMDs have the potential to be used as teaching aids in the robotic lab.
authors.affiliation: Department of Urology, Robotic Prostatectomy and Urologic-Oncology Outcomes, Weill Medical College of Cornell University, New York Presbyterian Hospital, Brady Urologic Health Center, 525 East 68th Street, Starr 900, New York, NY, 10021, USA.
authors.forename: Rajan
authors.initials: R
authors.lastname: Ramanathan
authors.forename: Juan I Martinez
authors.initials: JI
authors.lastname: Salamanca
authors.forename: Anil
authors.initials: A
authors.lastname: Mandhani
authors.forename: Robert A
authors.initials: RA
authors.lastname: Leung
authors.forename: Sandhya R
authors.initials: SR
authors.lastname: Rao
authors.forename: Roy
authors.initials: R
authors.lastname: Berryhill
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Tewari
mesh_terms: D002983:Clinical Competence; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D010823:Physician Assistants; D011468:Prostatectomy / Q000379:methods* / Q000592:standards*; D012371:Robotics / Q000592:standards*