Surgical Endoscopy

, Volume 26, Issue 10, pp 2961–2968 | Cite as

Three-dimensional vision enhances task performance independently of the surgical method

  • O. J. Wagner
  • M. Hagen
  • A. Kurmann
  • S. Horgan
  • D. Candinas
  • S. A. Vorburger



Within the next few years, the medical industry will launch increasingly affordable three-dimensional (3D) vision systems for the operating room (OR). This study aimed to evaluate the effect of two-dimensional (2D) and 3D visualization on surgical skills and task performance.


In this study, 34 individuals with varying laparoscopic experience (18 inexperienced individuals) performed three tasks to test spatial relationships, grasping and positioning, dexterity, precision, and hand–eye and hand–hand coordination. Each task was performed in 3D using binocular vision for open performance, the Viking 3Di Vision System for laparoscopic performance, and the DaVinci robotic system. The same tasks were repeated in 2D using an eye patch for monocular vision, conventional laparoscopy, and the DaVinci robotic system.


Loss of 3D vision significantly increased the perceived difficulty of a task and the time required to perform it, independently of the approach (P < 0.0001–0.02). Simple tasks took 25 % to 30 % longer to complete and more complex tasks took 75 % longer with 2D than with 3D vision. Only the difficult task was performed faster with the robot than with laparoscopy (P = 0.005). In every case, 3D robotic performance was superior to conventional laparoscopy (2D) (P < 0.001–0.015).


The more complex the task, the more 3D vision accelerates task completion compared with 2D vision. The gain in task performance is independent of the surgical method.


2D 3D laparoscopy 3D vision Robotic surgery Surgical skills Task performance 



Monika E. Hagen receives a salary from Intuitive Surgical Inc. However, the financial relation started after the current study was completed. O. J. Wagner, Anita Kurmann, S. Horgan, Daniel Candinas, and Stephan A. Vorburger have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • O. J. Wagner
    • 1
    • 2
  • M. Hagen
    • 1
    • 3
  • A. Kurmann
    • 1
  • S. Horgan
    • 2
  • D. Candinas
    • 1
  • S. A. Vorburger
    • 1
    • 4
  1. 1.Department of Visceral and Transplantation Surgery, InselspitalUniversity Hospital Bern and University of BernBernSwitzerland
  2. 2.Department of Surgery, Center for the Future of SurgeryUniversity of CaliforniaSan DiegoUSA
  3. 3.Division of Visceral SurgeryUniversity Hospital GenevaGenevaSwitzerland
  4. 4.Regional Hospital EmmentalBurgdorfSwitzerland

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