title: Usefulness of panoramic views for novice surgeons doing retroperitoneal laparoscopic nephrectomy.
abstract: OBJECTIVE
  Laparoscopic surgery is widely accepted for managing renal disease. Thus, the system used to educate and train novice surgeons in laparoscopic surgery becomes important to reduce the risks of surgery during their training. A prospective study was carried out to determine the usefulness of using panoramic views during laparoscopic surgery.
  
  
  METHODS
  Between April 2004 and March 2007, four novice surgeons started learning laparoscopic radical nephrectomy: two carried out surgery without panoramic views and two used panoramic views. Operating time and blood loss for the initial 10 cases of each surgeon were compared. Panoramic views were obtained by interlacing each video frame of the video images electronically; the images were then processed and displayed during each step of laparoscopic surgery.
  
  
  RESULTS
  Panoramic, real-time views could be obtained, and they served as navigation maps. The learning curve of surgeons using the panoramic views was shorter than that of surgeons who did not use panoramic views. Time to ligation of renal artery from port placement and the operating time was shorter (69.0 +/- 21.5 min vs 106.8 +/- 44.9 min, P = 0.0016, 212 +/- 42 min vs 254 +/- 46 min, P = 0.0489, respectively) and the estimated blood loss was less for the surgeons who used panoramic views (87 +/- 109 mL vs 334 +/- 268 mL, P = 0.0005).
  
  
  CONCLUSIONS
  Panoramic views during laparoscopic surgery shortened operating time and reduced blood loss, indicating their usefulness in assisting novice surgeons to carry out procedures safely and accurately.
authors.affiliation: Research Center for Frontier Medical Engineering, Chiba University, Chiba, Japan. nayayukio@faculty.chiba-u.jp
authors.forename: Yukio
authors.initials: Y
authors.lastname: Naya
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Araki
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.forename: Syuichi
authors.initials: S
authors.lastname: Kamijima
authors.forename: Takashi
authors.initials: T
authors.lastname: Imamoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Nihei
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Igarashi
mesh_terms: D006801:Humans; D007091:Image Processing, Computer-Assisted; D010535:Laparoscopy / Q000379:methods*; D009392:Nephrectomy / Q000193:education* / Q000379:methods; D011446:Prospective Studies