Abstract

Laparoscopic surgery provides well-known benefits, but it has technological limitations. Depth perception is particularly crucial, with three-dimensional (3D) imaging being superior to two-dimensional (2D) HD imaging. However, with the introduction of 4K resolution monitors, 2D rendering is capable of providing higher-quality visuals. Therefore, this study aimed to compare 3D HD and 2D 4K imaging using a pelvitrainer model. Eight experts and 32 medical students were performing the same four standardized tasks using 2D 4K and 3D HD imaging systems. Task completion time and the number of errors made were recorded. The Wilcoxon test and mixed-effects models were used to analyze the results. Students were significantly faster in all four tasks when using the 3D HD perspective. The median difference ranged from 18 s in task 3 (P < 0.003) up to 177.5 s in task 4 (P < 0.001). With the exception of task 4, students demonstrated significantly fewer errors in all tasks involving 3D HD imaging. The experts’ results confirmed these findings, as they were also faster in all four tasks using 3D HD, which was significant for task 1 (P < 0.001) and task 4 (P < 0.006). The expert group also achieved better movement accuracy using the 3D HD system, with fewer mistakes made in all four tasks, which was significant in task 4 (P < 0.001). Participants in both groups achieved better results with the 3D HD imaging system than with the 2D 4K system. The 3D HD image system should be used when available. Trial registration: this trial is registered at research registry under the identifier researchregistry6852.

Highlights

  • Laparoscopy has clear benefits in comparison to open surgery

  • The experts were faster and made fewer mistakes compared to the students with both systems. They completed the tasks in a median of 156 s and 11.5 mistakes with the 2D 4K system versus 86 s and 7 mistakes with the 3D HD system (P < 0.001 and P < 0.330, respectively) (Tables 1, 2, and 3)

  • The students were significantly faster with the 3D HD system (P < 0.003) with a median completion time of 134 s compared to 158 s with the 2D 4K system

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Summary

Introduction

Laparoscopy has clear benefits in comparison to open surgery. It enables reduced blood loss, a significant decline in the postoperative infection rate, shorter hospitalizations, and faster recovery times [1,2,3]. It has disadvantages that include technical limitations, limited degrees of freedom, unnatural ergonomics, and limitations in current instrument design and visualization [4]. High acquisition and maintenance costs, with no clear benefits in terms of inpatient hospital stays or operation times, mean the advantages of robotic-assisted laparoscopy do not completely outweigh the need for the conventional procedure [8, 9]

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