title: Impact of 3D in the training of basic laparoscopic skills and its transferability to 2D environment: a prospective randomized controlled trial.
abstract: Various studies have shown the benefit of three-dimensional (3D) systems over two-dimensional (2D) systems in laparoscopic surgery. However, a few studies have shown the impact of proficiency-based training and transferability of the skills from 2D to 3D system and vice versa.
  
  
  
  The purpose of this study was to investigate the impact of 2D and 3D environments on the time taken by novice trainees to learn basic laparoscopic skills and the transferability of the skills learnt in one environment to another.
  
  
  
  Medical students with no prior experience in training of laparoscopic tasks were randomly assigned to 2D or 3D groups. Both groups were trained in peg transfer and intracorporeal suture of Fundamentals of Laparoscopic Surgery (FLS) program until they attained predefined benchmarks. The practice times taken to reach the goal were compared. After they had reached the goal, all the participants were asked to repeat these tasks under both 2D and 3D environments. Their scores in both of the environments were compared.
  
  
  
  Eighty-eight participants were randomly assigned to 2D (n = 44) or 3D (n = 44) training groups. There was no difference between the backgrounds of both groups. The 3D training group was faster in reaching its goal in both tasks (p < 0.001 and p = 0.007, respectively). After reaching the goal, both groups were faster in the 3D environment in peg transfer (p = 0.04, p = 0.012). In intracorporeal suture, the 2D training group had similar scores in both the environments (p = 0.32), but the 3D group was slower in the 2D environment (p = <0.001).
  
  
  
  The 3D environment helped shorten the training time of basic laparoscopic skills to novices. However, the novices trained in the 3D environment failed to transfer their skills to the 2D environment.
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan.
authors.forename: Saseem
authors.initials: S
authors.lastname: Poudel
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan. yo.kurashima@huhp.hokudai.ac.jp.
authors.forename: Yo
authors.initials: Y
authors.lastname: Kurashima
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan.
authors.forename: Yuma
authors.initials: Y
authors.lastname: Ebihara
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Tamoto
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan.
authors.forename: Soichi
authors.initials: S
authors.lastname: Murakami
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsuchikawa
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Okamura
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shichinohe
authors.affiliation: Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 14 Nishi 5, Kita Ku, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirano
mesh_terms: D002983:Clinical Competence; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007564:Japan; D010535:Laparoscopy / Q000193:education*; D059032:Learning Curve; D008297:Male; D011446:Prospective Studies; D000066908:Simulation Training; D013337:Students, Medical
keywords: Intracorporeal suture; Proficiency-based training; Stereovision; Three-dimensional (3D) laparoscopy; Transferability; Two-dimensional (2D) laparoscopy