The Conflicting Evidence of Three-dimensional Displays in Laparoscopy: A Review of Systems Old and New.
OBJECTIVE
To describe studies evaluating 3 generations of three-dimensional (3D) displays over the course of 20 years.


BACKGROUND
Most previous studies have analyzed performance differences during 3D and two-dimensional (2D) laparoscopy without using appropriate controls that equated conditions in all respects except for 3D or 2D viewing.


METHODS
Databases search consisted of MEDLINE and PubMed. The reference lists for all relevant articles were also reviewed for additional articles. The search strategy employed the use of keywords "3D," "Laparoscopic," "Laparoscopy," "Performance," "Education," "Learning," and "Surgery" in appropriate combinations.


RESULTS
Our current understanding of the performance metrics between 3D and 2D laparoscopy is mostly from the research with flawed study designs. This review has been written in a qualitative style to explain in detail how prior research has underestimated the potential benefit of 3D displays and the improvements that must be made in future experiments comparing 3D and 2D displays to better determine any advantage of using one display or the other.


CONCLUSIONS
Individual laparoscopic performance in 3D may be affected by a multitude of factors. It is crucial for studies to measure participant stereoscopic ability, control for system crosstalk, and use validated measures of performance.
*School of Medicine, The University of Queensland, Brisbane, Queensland, Australia †Clinical Skills Development Service, Queensland Health, Herston, Queensland, Australia ‡Department of Colon and Rectal Surgery, Royal Brisbane and Women's Hospital, The University of Queensland, Brisbane, Queensland, Australia §School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
Shinichiro
S
Sakata
Marcus O
MO
Watson
Philip M
PM
Grove
Andrew R L
AR
Stevenson
D002983:Clinical Competence; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011597:Psychomotor Performance