Basic Laparoscopic Skills Training is Equally Effective Using Either 2d or 3d Visualization: A Randomized Controlled Trial

Abstract

Study Objective To assess whether basic laparoscopic skills (BLS) training on a standard laparoscopic box trainer using 2D visualization is at least equally effective compared to 3D. Design Randomized controlled trial. Setting Tertiary care center, Vienna, Austria. Patients or Participants A total of 32 medical students of the Medical University of Vienna were recruited. Interventions Participants were randomized to BLS training using either 2D or 3D visualization and trained four Fundamentals of Laparoscopic Surgery (FLS) tasks for one hour twice a week for four weeks. Baseline and post training tests were performed. Improvement in total test scores and the scores for the four individual FLS tasks within the assigned visualization modality was assessed. The non-inferiority margin was set as 10% of the mean improvement in the 3D group. Measurements and Main Results Data of 31 participants were analysed (n=16 in the 2D, n=15 in the 3D group, n=1 drop out). Baseline test scores did not differ significantly between groups except for the peg transfer task and total scores, where participants in the 3D group scored better than those in the 2D group. Total scores as well as the scores for all four tasks separately improved significantly in both groups. Post training test total and single task scores did not differ significantly between the groups. Non-inferiority of 2D compared to 3D training modality could be demonstrated for the improvement in total scores and in all individual FLS tasks, except for the suturing with extracorporeal knot tying task. Only the peg transfer task showed superiority in score improvement in the 2D compared to the 3D group. Conclusion Learning BLS using standard 2D visualization is at least equally effective as with 3D visualization. 3D visualization seems to offer a slight advantage at baseline testing, but does not translate to better test scores at post training testing.