title: Stereoscopic (3D) versus monoscopic (2D) laparoscopy: comparative study of performance using advanced HD optical systems in a surgical simulator model.
abstract: OBJECTIVE
  To compare task performances of novices and experts using advanced high-definition 3D versus 2D optical systems in a surgical simulator model.
  
  
  METHODS
  Fifty medical students (novices in laparoscopy) were randomly assigned to perform five standardized tasks adopted from the Fundamentals of Laparoscopic Surgery (FLS) curriculum in either a 2D or 3D laparoscopy simulator system. In addition, eight experts performed the same tasks. Task performances were evaluated using a validated scoring system of the SAGES/FLS program. Participants were asked to rate 16 items in a questionnaire.
  
  
  RESULTS
  Overall task performance of novices was significantly better using stereoscopic visualization. Superiority of performances in 3D reached a level of significance for tasks peg transfer and precision cutting. No significant differences were noted in performances of experts when using either 2D or 3D. Overall performances of experts compared to novices were better in both 2D and 3D. Scorings in the questionnaires showed a tendency toward lower scores in the group of novices using 3D.
  
  
  CONCLUSIONS
  Stereoscopic imaging significantly improves performance of laparoscopic phantom tasks of novices. The current study confirms earlier data based on a large number of participants and a standardized task and scoring system. Participants felt more confident and comfortable when using a 3D laparoscopic system. However, the question remains open whether these findings translate into faster and safer operations in a clinical setting.
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Schoenthaler
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schnell
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Konrad
authors.initials: K
authors.lastname: Wilhelm
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schlager
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Adams
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Hein
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wetterauer
authors.affiliation: Department of Urology, University Medical Centre Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany. arkadiusz.miernik@uniklinik-freiburg.de.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Miernik
mesh_terms: D002983:Clinical Competence; D004501:Education, Medical / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D021621:Imaging, Three-Dimensional; D020706:Laparoscopes; D010535:Laparoscopy / Q000193:education*; D008953:Models, Anatomic; D055096:Optical Devices; D014572:Urology / Q000193:education*
keywords: 3D laparoscopy; Dry lab; High-definition optical system; High-definition video; Monoscopic laparoscopy; Stereoscopic laparoscopy