title: Impact of 3D vision on mental workload and laparoscopic performance in inexperienced subjects.
abstract: OBJECTIVE
  To assess the effect of vision in three dimensions (3D) versus two dimensions (2D) on mental workload and laparoscopic performance during simulation-based training.
  
  
  METHODS
  A prospective, randomized crossover study on inexperienced students in operative laparoscopy was conducted. Forty-six candidates executed five standardized exercises on a pelvitrainer with both vision systems (3D and 2D). Laparoscopy performance was assessed using the total time (in seconds) and the number of failed attempts. For workload assessment, the validated NASA-TLX questionnaire was administered.
  
  
  RESULTS
  3D vision improves the performance reducing the time (3D = 1006.08 ± 315.94 vs. 2D = 1309.17 ± 300.28; P < .001) and the total number of failed attempts (3D = .84 ± 1.26 vs. 2D = 1.86 ± 1.60; P < .001). For each exercise, 3D vision also shows better performance times: "transfer objects" (P = .001), "single knot" (P < .001), "clip and cut" (P < .05), and "needle guidance" (P < .001). Besides, according to the NASA-TLX results, less mental workload is experienced with the use of 3D (P < .001). However, 3D vision was associated with greater visual impairment (P < .01) and headaches (P < .05).
  
  
  CONCLUSIONS
  The incorporation of 3D systems in laparoscopic training programs would facilitate the acquisition of laparoscopic skills, because they reduce mental workload and improve the performance on inexperienced surgeons. However, some undesirable effects such as visual discomfort or headache are identified initially.
authors.affiliation: Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España. Electronic address: enriquegomezgomez@yahoo.es.
authors.forename: E
authors.initials: E
authors.lastname: Gómez-Gómez
authors.affiliation: Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: J
authors.initials: J
authors.lastname: Carrasco-Valiente
authors.affiliation: Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: J
authors.initials: J
authors.lastname: Valero-Rosa
authors.affiliation: Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: J P
authors.initials: JP
authors.lastname: Campos-Hernández
authors.affiliation: Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Anglada-Curado
authors.affiliation: Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: J L
authors.initials: JL
authors.lastname: Carazo-Carazo
authors.affiliation: Departamento de Medicina, Hospital Universitario Reina Sofía/IMIBIC/Universidad de Córdoba, Córdoba, España.
authors.forename: P
authors.initials: P
authors.lastname: Font-Ugalde
authors.affiliation: Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Requena-Tapia
mesh_terms: D002983:Clinical Competence; D018592:Cross-Over Studies; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000009:adverse effects; D010535:Laparoscopy / Q000379:methods / Q000523:psychology*; D008297:Male; D005222:Mental Fatigue / Q000209:etiology; D011446:Prospective Studies; D011597:Psychomotor Performance; D000066908:Simulation Training; D066231:Surgeons / Q000523:psychology*; D011795:Surveys and Questionnaires; D013520:Urologic Surgical Procedures; D014786:Vision Disorders / Q000209:etiology; D055815:Young Adult
keywords: 2D imaging; 3D imaging; Carga mental de trabajo; Cirugía laparoscópica; Imagen 2D; Imagen 3D; Laparoscopic surgery; Mental workload