Abstract
Background and AimsPublished studies repeatedly demonstrate an advantage of three-dimensional (3D) laparoscopic surgery over two-dimensional (2D) systems but with quite heterogeneous results. This raises the question whether clinics must replace 2D technologies to ensure effective training of future surgeons.MethodsWe recruited 45 students with no experience in laparoscopic surgery and comparable characteristics in terms of vision and frequency of video game usage. The students were randomly allocated to 3D (n = 23) or 2D (n = 22) groups and performed 10 runs of a laparoscopic “peg transfer” task in the Luebeck Toolbox. A repeated-measures ANOVA for operation times and a generalized linear mixed model for error rates were calculated. The main effects of laparoscopic condition and run, as well as the interaction term between the two, were examined.ResultsNo statistically significant differences in operation times and error rates were observed between 2D and 3D groups (p = 0.10 and p = 0.72, respectively). The learning curve showed a significant reduction in operation time and error rates (both p's < 0.001). No significant interactions between group and run were detected (operation time: p = 0.342, error rates: p = 0.83). With respect to both endpoints studied, the learning curves reached their plateau at the 7th run.ConclusionThe result of our study with laparoscopic novices revealed no significant difference between 2D and 3D technology with respect to performance time and the error rate in a simple standardized test. In the future, surgeons may thus still be trained in both techniques.
Highlights
Laparoscopy is a state-of-the-art technique in abdominal surgery clinics today due to the undeniable benefits of its lower invasiveness
The mean values of time required to perform each of the 10 test runs showed no significant difference between the two dimensional (2D)/HD and three dimensional (3D) groups (Figure 2)
A systematic review of laparoscopic cholecystectomy by Komaei et al showed a significant advantage of 3D laparoscopy in 60% with respect to operating time [8], while two recent clinical studies comparing 2D/HD vs. 3D laparoscopic right hemicolectomy detected no significant difference with respect to intra- and postoperative complications and confirm equivalent patient outcomes [9, 10]
Summary
Laparoscopy is a state-of-the-art technique in abdominal surgery clinics today due to the undeniable benefits of its lower invasiveness. The development of high-definition (HD) camera systems with higher resolution, more brightness, and less distortion resulted in measurable technological progress of 2D (two-dimensional) video systems in practice [1]. A stereoscopic view might, be beneficial due to an improved depth perception, and many studies, demonstrate advantages of 3D over 2D/HD systems, which are reflected in a reduced performance time and lower number of errors in daily clinical practice. Published studies repeatedly demonstrate an advantage of three-dimensional (3D) laparoscopic surgery over two-dimensional (2D) systems but with quite heterogeneous results. This raises the question whether clinics must replace 2D technologies to ensure effective training of future surgeons
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