title: Quantitative comparison of operative skill using 2- and 3-dimensional monitors during laparoscopic phantom tasks.
abstract: The recent development of stereoscopic images using 3-dimensional monitors is expected to improve techniques for laparoscopic operation. Several studies have reported technical advantages in using 3-dimensional monitors with regard to operative accuracy and working speed, but there are few reports that analyze forceps motions by 3-dimensional optical tracking systems during standardized laparoscopic phantom tasks. We attempted to develop a 3-dimensional motion analysis system for assessing laparoscopic tasks and to clarify the efficacy of using stereoscopic images from a 3-dimensional monitor to track forceps movement during laparoscopy.
  
  
  
  Twenty surgeons performed 3 tasks (Task 1: a simple operation by the dominant hand, Task 2: a simple operation using both hands, Task 3: a complicated operation using both hands) under 2-dimensional and 3-dimensional systems. We tracked and recorded the motion of forceps tips with an optical marker captured by a 3-dimensional position tracker. We analyzed factors such as forceps path lengths, operation times, and technical errors for each task and compared the results of 2-dimensional and 3-dimensional monitors.
  
  
  
  Mean operation times and technical errors were improved significantly for all tasks performed under the 3-dimensional system compared with the 2-dimensional system; in addition, mean path lengths for the forceps tips were shorter for all tasks performed under the 3-dimensional system.
  
  
  
  We found that stereoscopic images using a 3-dimensional monitor improved operative techniques with regard to increased accuracy and shorter path lengths for forceps movement, which resulted in a shorter operation time for basic phantom laparoscopic tasks.
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: mnishi@med.kobe-u.ac.jp.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Nishi
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kanaji
authors.affiliation: Graduate School of Information Science, Nara Institute of Science and Technology, Nara, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Otake
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Harada
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Oshikiri
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Graduate School of Information Science, Nara Institute of Science and Technology, Nara, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Graduate School of Information Science, Nara Institute of Science and Technology, Nara, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Hiasa
authors.affiliation: Graduate School of Information Science, Nara Institute of Science and Technology, Nara, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kakeji
mesh_terms: D002983:Clinical Competence; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000193:education*; D061646:Operative Time; D019047:Phantoms, Imaging; D011597:Psychomotor Performance; D000066908:Simulation Training; D013525:Surgical Instruments