Three-dimensional imaging improved the laparoscopic performance of inexperienced operators: a prospective trial
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and Other Interventional Techniques
Three‑dimensional imaging improved the laparoscopic performance of inexperienced operators: a prospective trial Shingo Kanaji1,5 · Ryohei Watanabe1 · Pietro Mascagni2,4 · Fabian Trauzettel2 · Takeshi Urade2 · Fabio Longo2 · Ludovica Guerriero2 · Silvana Perretta1,2,3 · Bernard Dallemagne1,2,3 · Yoshihiro Kakeji5 · Jacques Marescaux1,2 Received: 3 August 2019 / Accepted: 28 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Background Three-dimensional (3-D) high-definition (HD) stereovision and two-dimensional (2-D) ultra-high-resolution (4K) monitors have recently become available for laparoscopic surgery. The aim of this study was to compare laparoscopic performance between inexperienced participants using 3-D/HD and 2-D/4K monitors and those using conventional 2-D/ HD monitors. Methods The study enrolled 66 participants with no previous surgical experience or medical training. They were randomly divided into three equal groups, each using a different type of monitor (2-D/HD, 2-D/4K, or 3-D/HD), to perform three phantom tasks using a laparoscopic simulator: Task 1, touching markers on a non-flat surface; Task 2, bimanual peg transfer; and Task 3, passing a straight rod through a loop. Each task was performed three times. The performance scores (operative time, path length of the forceps, and technical errors) were compared for each monitor type and by age group ( 30 years). Results For all three tasks, scores using the 3-D monitor were significantly better than those using either 2-D monitor, with no difference between the 2-D/4K and 2-D/HD monitors. Using the 2-D monitors, the performance of Task 3 by the participants > 30 years was worse than that by the younger participants; however, there was no difference between the age groups when using the 3-D monitor. Conclusion Participants with no prior experience using a 3-D monitor showed better laparoscopic performance than those using 2-D monitors, even with 4K resolution. This improvement was more marked in older participants, suggesting a greater loss of depth perception in a 2-D environment. Keywords 3-D/HD laparoscopy · 2-D/4K laparoscopy · Naive operators · Task performance Several new imaging technologies used for consumer-grade television have recently become available for laparoscopic surgery, including stereoscopic three-dimensional (3-D) * Shingo Kanaji [email protected]‑u.ac.jp 1
IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
2
IHU-Strasbourg, Institute of Image‐Guided Surgery, Strasbourg, France
3
Department of General, Digestive, and Endocrine Surgery, University of Strasbourg, Strasbourg, France
4
Centre for Endoscopic Research Therapeutics and Training, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
5
Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
high-definition (HD) video and two-dimensional (2-D) ultrahigh-resolution (4K)
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