title: Three-dimensional Laparoscopy: Does Improved Visualization Decrease the Learning Curve Among Trainees in Advanced Procedures?
abstract: OBJECTIVE
  Complex laparoscopy is difficult to master because it involves 3-dimensional (3D) interpretation on a 2-dimensional (2D) viewing screen. The use of 3D technology has an uncertain effect on training surgeons. We aim to evaluate the effectiveness of 3D on learning and performing laparoscopic tasks.
  
  
  METHODS
  Medical students without laparoscopic experience (novices) were evaluated doing inanimate object transfer and laparoscopic suturing. Tasks were repeated using 2D and 3D cameras with standard instruments. Time and error rates (missed attempts, dropped objects, and failure to complete the task) were recorded.
  
  
  RESULTS
  Twenty-nine novice medical students experienced a 45.5% decrease in the time to complete PEG transfer using 3D (mean 207 s with 2D vs. 113 s with 3D). Error rate was reduced to 50% (2D, 4 errors vs. 3D, 2 errors) and mean drop rate was reduced to 0. Similar decreases in suture time (46.5%) were seen (mean 403 s with 2D vs. 220 s with 3D).
  
  
  CONCLUSIONS
  Our results indicate that 3D significantly improved visualization and ability to perform complex tasks in the skills laboratory setting. This technology may be very effective in teaching advanced laparoscopic skills in the era of work-hour restrictions.
authors.affiliation: Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Kyle G
authors.initials: KG
authors.lastname: Cologne
authors.forename: Joerg
authors.initials: J
authors.lastname: Zehetner
authors.forename: Loriel
authors.initials: L
authors.lastname: Liwanag
authors.forename: Christian
authors.initials: C
authors.lastname: Cash
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Senagore
authors.forename: John C
authors.initials: JC
authors.lastname: Lipham
mesh_terms: D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D010535:Laparoscopy / Q000193:education* / Q000379:methods*; D059032:Learning Curve; D015203:Reproducibility of Results; D013337:Students, Medical