title: Assessment of Laparoscopic Skills Performance: 2D Versus 3D Vision and Classic Instrument Versus New Hand-Held Robotic Device for Laparoscopy.
abstract: OBJECTIVE
  Laparoscopic surgery has undeniable advantages, such as reduced postoperative pain, smaller incisions, and faster recovery. However, to improve surgeons' performance, ergonomic adaptations of the laparoscopic instruments and introduction of robotic technology are needed. The aim of this study was to ascertain the influence of a new hand-held robotic device for laparoscopy (HHRDL) and 3D vision on laparoscopic skills performance of 2 different groups, naïve and expert.
  
  
  METHODS
  Each participant performed 3 laparoscopic tasks-Peg transfer, Wire chaser, Knot-in 4 different ways. With random sequencing we assigned the execution order of the tasks based on the first type of visualization and laparoscopic instrument. Time to complete each laparoscopic task was recorded and analyzed with one-way analysis of variance.
  
  
  RESULTS
  Eleven experts and 15 naïve participants were included. Three-dimensional video helps the naïve group to get better performance in Peg transfer, Wire chaser 2 hands, and Knot; the new device improved the execution of all laparoscopic tasks (P < .05). For expert group, the 3D video system benefited them in Peg transfer and Wire chaser 1 hand, and the robotic device in Peg transfer, Wire chaser 1 hand, and Wire chaser 2 hands (P < .05).
  
  
  CONCLUSIONS
  The HHRDL helps the execution of difficult laparoscopic tasks, such as Knot, in the naïve group. Three-dimensional vision makes the laparoscopic performance of the participants without laparoscopic experience easier, unlike those with experience in laparoscopic procedures.
authors.affiliation: ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
authors.forename: Mariana
authors.initials: M
authors.lastname: Leite
authors.affiliation: ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal General Surgery, Hospital de Braga, Portugal.
authors.forename: Ana F
authors.initials: AF
authors.lastname: Carvalho
authors.affiliation: ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
authors.forename: Patrício
authors.initials: P
authors.lastname: Costa
authors.affiliation: DIGARC, Polytechnic Institute of Cávado and Ave, Barcelos, Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pereira
authors.affiliation: DIGARC, Polytechnic Institute of Cávado and Ave, Barcelos, Portugal.
authors.forename: Antonio
authors.initials: A
authors.lastname: Moreira
authors.affiliation: DIGARC, Polytechnic Institute of Cávado and Ave, Barcelos, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Rodrigues
authors.affiliation: ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
authors.forename: Sara
authors.initials: S
authors.lastname: Laureano
authors.affiliation: ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Correia-Pinto
authors.affiliation: ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
authors.forename: João L
authors.initials: JL
authors.lastname: Vilaça
authors.affiliation: ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal General Surgery, Hospital de Braga, Portugal pedroleao@ecsaude.uminho.pt.
authors.forename: Pedro
authors.initials: P
authors.lastname: Leão
mesh_terms: D002983:Clinical Competence; D006804:Ergonomics / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000295:instrumentation*; D065287:Robotic Surgical Procedures / Q000193:education* / Q000295:instrumentation*; D066231:Surgeons / Q000193:education* / Q000706:statistics & numerical data
keywords: ergonomics; human factors study; robotic surgery; surgical education