Three-dimensional laparoscopic imaging improves surgical performance on standardized ex-vivo laparoscopic tasks.
OBJECTIVE
Conventional two-dimensional (2D) laparoscopy has been limited by the lack of depth perception and spatial orientation. This disadvantage may affect surgical performance, operative time, or morbidity. Depth perception, spatial resolution, and accuracy may be improved by three-dimensional (3D) vision. This study was designed to evaluate the effect of 3D imaging on the performance of novice and experienced laparoscopic surgeons executing standardized laparoscopic tasks in an ex-vivo setting.


METHODS
A 3D imaging system with a digital 3D full high definition (HD) and a 2D imaging with a conventional HDTV camera were used. A total of 10 laparoscopic experts and 10 novices were evaluated while performing standardized skill tasks in a pelvic trainer. Participants were divided into two groups working either with 2D or 3D imaging. The parameters measured were time until completion of each skill and total procedure time, number of losses of working material, number of missed grasps, and number of needed support. Statistical analysis was performed using the Wilcoxon test.


RESULTS
The results showed a significant difference in favor of the 3D system for the amount of missed grasps in the experts as well as the novice group (P<0.0001). A slightly significant difference was also seen for the loss of working materials (P=0.0381 and P=0.0693). The study is limited by its small sample size.


CONCLUSIONS
The 3D imaging system significantly improves spatial orientation and depth perception during laparoscopy under ex-vivo conditions.
Department of Urology, Klinikum Sindelfingen-Böblingen, Sindelfingen, Germany. p.honeck@klinikverbund-suedwest.de
Patrick
P
Honeck
Gunnar
G
Wendt-Nordahl
Jens
J
Rassweiler
Thomas
T
Knoll
D002983:Clinical Competence; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D010535:Laparoscopy / Q000379:methods* / Q000592:standards*; D012015:Reference Standards; D013647:Task Performance and Analysis