title: Advanced stereoscopic projection technology significantly improves novice performance of minimally invasive surgical skills.
abstract: BACKGROUND
  Three-dimensional (3D) surgical imaging systems provide stereoscopic depth cues that are lost in conventional two-dimensional (2D) display systems. Recent improvements in stereoscopic projection technology using passive polarising displays may improve performance of minimally invasive surgical skills. This study aims to identify the effect of passive polarising stereoscopic displays on novice surgeon performance of minimally invasive surgical skills.
  
  
  METHODS
  20 novice surgeons performed 10 repetitions of 4 surgical skills tasks using a new passive polarising stereoscopic display under 3D and 2D conditions. The previously validated tasks used were rope pass, paper cut, needle capping and knot tying. Outcome measures included total error rate and time for task completion.
  
  
  RESULTS
  Novice surgeons demonstrated a significant reduction in error rates for sequential repetitions of each task using the passive polarising stereoscopic display compared with the 2D display. Mean errors for the 3D versus the 2D mode were 2.0 versus 4.3 for rope pass (P ≤ 0.001), 0.8 versus 1.6 for paper cut (P = 0.001), 1.3 versus 4.2 for needle capping (P ≤ 0.001) and 2.8 versus 8.0 for knot tying (P ≤ 0.001). Novice surgeons demonstrated a significant improvement in mean time for completion for all four tasks when using the 3D system. Mean time (in seconds) for 3D versus 2D were 106.5 versus 134.4 for rope pass (P ≤ 0.001), 116.1 versus 176.3 for paper cut (P ≤ 0.001), 76.3 versus 141.6 for needle capping (P ≤ 0.001) and 153.4 versus 252.6 for knot tying (P ≤ 0.001).
  
  
  CONCLUSIONS
  Passive polarising stereoscopic displays significantly improve novice surgeon performance during acquisition of minimally invasive surgical skills.
authors.affiliation: Minimal Access Therapy Training Unit, Post Graduate Medical School, University of Surrey, Manor Park, Guildford, Surrey GU2 7WG, UK.
authors.forename: R
authors.initials: R
authors.lastname: Smith
authors.forename: A
authors.initials: A
authors.lastname: Day
authors.forename: T
authors.initials: T
authors.lastname: Rockall
authors.forename: K
authors.initials: K
authors.lastname: Ballard
authors.forename: M
authors.initials: M
authors.lastname: Bailey
authors.forename: I
authors.initials: I
authors.lastname: Jourdan
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004501:Education, Medical / Q000379:methods; D019723:Endoscopes; D004867:Equipment Design; D005139:Eyeglasses; D005260:Female; D013502:General Surgery / Q000193:education / Q000592:standards*; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000193:education / Q000295:instrumentation / Q000592:standards*; D059032:Learning Curve; D008297:Male; D011597:Psychomotor Performance / Q000502:physiology; D013997:Time Factors