title: Two-dimensional versus three-dimensional laparoscopy: evaluation of physicians' performance and preference using a pelvic trainer.
abstract: OBJECTIVE
  To compare the proficiency and preference of physicians in performing standard tasks in a box trainer using 2-dimensional (2D) versus 3-dimensional (3D) laparoscopy.
  
  
  METHODS
  Prospective randomized controlled trial.
  
  
  METHODS
  Prospective, randomized controlled trial (Canadian Task Force classification I).
  
  
  METHODS
  Tertiary care teaching hospital.
  
  
  METHODS
  Thirty physicians from the Department of Obstetrics and Gynecology.
  
  
  METHODS
  Participants were randomly assigned to perform a set of 3 to 4 tasks in a pelvic trainer using 2D laparoscopy first and then 3D laparoscopy, and vice versa.
  The time taken to complete the tasks and side effects experienced were noted. Participants were asked to complete a modified Global Operative Assessment of Laparoscopic Skills (GOALS) form at the end of their tasks to evaluate their experiences and to assess their own proficiency with both visual modalities.
  
  
  RESULTS
  The time taken for peg transfer, duct cannulation, and suturing was significantly faster using 3D laparoscopy compared with 2D laparoscopy. There were no significant differences in the time taken for pattern cutting with both visual modalities. Participants experienced more dizziness using 3D laparoscopy (6.9% vs 37.9%; p = .004). The GOALS self-evaluation score was significantly higher for 3D compared with 2D laparoscopy. After the study, 11 of 29 (37.9%) participants preferred 2D, 16 of 29 (55.2%) preferred 3D, and 1 of 29 (8.3%) had no preference.
  
  
  CONCLUSIONS
  Although 3D laparoscopy scored higher on self-evaluation and was preferred by more participants, it only gave better objective performance in the completion of some selected tasks by participants with intermediate skill levels and was associated with more dizziness. Further studies are needed to determine the value of 3D laparoscopy, especially when used in the clinical setting.
authors.affiliation: Department of Obstetrics and Gynecology, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong. Electronic address: jenko@hku.hk.
authors.forename: Jennifer K Y
authors.initials: JK
authors.lastname: Ko
authors.affiliation: Department of Obstetrics and Gynecology, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong.
authors.forename: Raymond H W
authors.initials: RH
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong.
authors.forename: Vincent Y T
authors.initials: VY
authors.lastname: Cheung
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D006176:Gynecology / Q000193:education*; D006723:Hong Kong; D006801:Humans; D021621:Imaging, Three-Dimensional; D007318:Inservice Training / Q000379:methods*; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods; D008297:Male; D010820:Physicians / Q000592:standards; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis
keywords: 3-dimensional; Box trainer; Laparoscopy