title: 3D HD versus 2D HD: surgical task efficiency in standardised phantom tasks.
abstract: BACKGROUND
  Common video systems for laparoscopy provide the surgeon a two-dimensional image (2D), where information on spatial depth can be derived only from secondary spatial depth cues and experience. Although the advantage of stereoscopy for surgical task efficiency has been clearly shown, several attempts to introduce three-dimensional (3D) video systems into clinical routine have failed. The aim of this study is to evaluate users' performances in standardised surgical phantom model tasks using 3D HD visualisation compared with 2D HD regarding precision and working speed.
  
  
  METHODS
  This comparative study uses a 3D HD video system consisting of a dual-channel laparoscope, a stereoscopic camera, a camera controller with two separate outputs and a wavelength multiplex stereoscopic monitor. Each of 20 medical students and 10 laparoscopically experienced surgeons (more than 100 laparoscopic cholecystectomies each) pre-selected in a stereo vision test were asked to perform one task to familiarise themselves with the system and subsequently a set of five standardised tasks encountered in typical surgical procedures. The tasks were performed under either 3D or 2D conditions at random choice and subsequently repeated under the other vision condition. Predefined errors were counted, and time needed was measured.
  
  
  RESULTS
  In four of the five tasks the study participants made fewer mistakes in 3D than in 2D vision. In four of the tasks they needed significantly more time in the 2D mode. Both the student group and the surgeon group showed similarly improved performance, while the surgeon group additionally saved more time on difficult tasks.
  
  
  CONCLUSIONS
  This study shows that 3D HD using a state-of-the-art 3D monitor permits superior task efficiency, even as compared with the latest 2D HD video systems.
authors.affiliation: Department of General, Visceral and Transplant Surgery, Workgroup Experimental Minimally Invasive Surgery and Training, University Hospital Tuebingen, Waldhoernlestrasse 22, 72072, Tuebingen, Germany.
authors.forename: Pirmin
authors.initials: P
authors.lastname: Storz
authors.forename: Gerhard F
authors.initials: GF
authors.lastname: Buess
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kunert
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirschniak
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004724:Endoscopy / Q000592:standards*; D004867:Equipment Design; D013502:General Surgery / Q000592:standards*; D006801:Humans; D008953:Models, Anatomic; D011597:Psychomotor Performance / Q000502:physiology; D020535:Video-Assisted Surgery / Q000592:standards*