Abstract
In laparoscopy, novel three-dimensional laparoscopic vision systems (3D LVS) without glasses (3D−) have been invented. While standard 3D LVS with glasses (3D+) have shown advantages over original two-dimensional systems, quantitative comparisons of surgical performance between 3D− and 3D+ systems are still lacking. The aim is to compare the systems in simulated robotic surgery tasks. In a crossover study, 18 medical students performed four basic laparoscopic tasks in the validated Simball Box simulator with authentic surgical instruments by using the 3D+ and 3D− systems. Performance was measured by the number of errors and the task’s duration. Subjective ratings of perceptions and preference were assessed after each test. There were significant, but still minor, advantages for the conventional 3D+ system regarding spatial orientation and sense of depth. Overall, ten and eight subjects preferred 3D+ and 3D− systems, respectively. No significant differences were found in performance, post-operative physicals or eye symptoms. The novel 3D− system was similar to the conventional 3D+ system regarding performance and overall preference, while there were minor advantages for the 3D+ system in the subjective ratings. Since the 3D− system is a new invention, it should have a higher potential of usability improvements.
Highlights
Today, minimally invasive surgery is an established technique in various surgical procedures, and the development in this field continues
Due to technical difficulty, we did not obtain a video recording during the first peg transfer task for three of the participants. They were excluded from the counting of errors in that task. These three participants all started with the 3D− system
We had technical problems with another subject in the peg transfer task in the path length measurement; the subject was excluded from the calculations of path length as well. This was a participant that started with the 3D− system as well
Summary
Minimally invasive surgery is an established technique in various surgical procedures, and the development in this field continues. The original two-dimensional laparoscopic vision system (2D LVS) is being challenged by three-dimensional systems (3D LVS) that provide a stereoscopic perception [1,2,3,4,5]. The advantages reported with 3D vision systems in surgery are shorter operative time, less blood loss, fewer perioperative complications, and shorter length of hospital stay, according to a large meta-analysis performed by Cheng et al [4]. The 3D LVS is proven to be better in terms of shorter task durations, reduced error rates, and a better subjective experience [3,5,6].
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