Advertisement

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
Article

Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.

Keywords

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

Notes

Disclosures

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.

References

  1. 1.
    Dagher I, Di Giuro G, Dubrez J, Lainas P, Smadja C, Franco D (2009) Laparoscopic versus open right hepatectomy: a comparative study. Am J Surg 198:173–177PubMedCrossRefGoogle Scholar
  2. 2.
    Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ (2006) Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev (4):CD006231Google Scholar
  3. 3.
    Laine S, Rantala A, Gullichsen R, Ovaska J (1997) Laparoscopic vs conventional Nissen fundoplication: a prospective randomized study. Surg Endosc 11:441–444PubMedCrossRefGoogle Scholar
  4. 4.
    Medeiros LR, Stein AT, Fachel J, Garry R, Furness S (2008) Laparoscopy versus laparotomy for benign ovarian tumor: a systematic review and meta-analysis. Int J Gynecol Cancer 18:387–399PubMedCrossRefGoogle Scholar
  5. 5.
    Sauerland S, Lefering R, Neugebauer EA (2004) Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev (4):CD001546Google Scholar
  6. 6.
    Avital S, Zundel N, Szomstein S, Rosenthal R (2005) Laparoscopic transhiatal esophagectomy for esophageal cancer. Am J Surg 190(1):69–74PubMedCrossRefGoogle Scholar
  7. 7.
    Sinha CK, Paramalingam S, Patel S, Davenport M, Ade-Ajayi N (2009) Feasibility of complex minimally invasive surgery in neonates. Pediatr Surg Int 25:217–221PubMedCrossRefGoogle Scholar
  8. 8.
    Heemskerk J, Zandbergen R, Maessen JG, Greve JW, Bouvy ND (2006) Advantages of advanced laparoscopic systems. Surg Endosc 20:730–733PubMedCrossRefGoogle Scholar
  9. 9.
    Gallagher AG, Ritter EM, Lederman AB, McClusky DA III, Smith CD (2005) Video-assisted surgery represents more than a loss of three-dimensional vision. Am J Surg 189:76–80PubMedCrossRefGoogle Scholar
  10. 10.
    Hubber JW, Taffinder N, Russell RC, Darzi A (2003) The effects of different viewing conditions on performance in simulated minimal access surgery. Ergonomics 46:999–1016PubMedCrossRefGoogle Scholar
  11. 11.
    Risucci D, Geiss A, Gellman L, Pinard B, Rosser J (2001) Surgeon-specific factors in the acquisition of laparoscopic surgical skills. Am J Surg 181:289–293PubMedCrossRefGoogle Scholar
  12. 12.
    Byrn JC, Schluender S, Divino CM, Conrad J, Gurland B, Shlasko E, Szold A (2007) Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System. Am J Surg 193:519–522PubMedCrossRefGoogle Scholar
  13. 13.
    Goldstein E (2003) Blackwell handbook of sensation and perception, 6th edn. Wiley, EngelskaGoogle Scholar
  14. 14.
    Bhayani SB, Andriole GL (2005) Three-dimensional (3D) vision: does it improve laparoscopic skills? An assessment of a 3D head-mounted visualization system. Rev Urol 7:211–214PubMedGoogle Scholar
  15. 15.
    Buess GF, van Bergen P, Kunert W, Schurr MO (1996) Comparative study of various 2-D and 3-D vision systems in minimally invasive surgery. Chirurg 67:1041–1046PubMedCrossRefGoogle Scholar
  16. 16.
    Chan AC, Chung SC, Yim AP, Lau JY, Ng EK, Li AK (1997) Comparison of two-dimensional vs three-dimensional camera systems in laparoscopic surgery. Surg Endosc 11:438–440PubMedCrossRefGoogle Scholar
  17. 17.
    Dion YM, Gaillard F (1997) Visual integration of data and basic motor skills under laparoscopy: influence of 2-D and 3-D video-camera systems. Surg Endosc 11:995–1000PubMedCrossRefGoogle Scholar
  18. 18.
    Hanna GB, Cuschieri A (2000) Influence of two-dimensional and three-dimensional imaging on endoscopic bowel suturing. World J Surg 24:444–448 discussion 448–449PubMedCrossRefGoogle Scholar
  19. 19.
    Hanna GB, Shimi SM, Cuschieri A (1998) Randomised study of influence of two-dimensional versus three-dimensional imaging on performance of laparoscopic cholecystectomy. Lancet 351:248–251PubMedCrossRefGoogle Scholar
  20. 20.
    Herron DM, Lantis JC II, Maykel J, Basu C, Schwaitzberg SD (1999) The 3-D monitor and head-mounted display: a quantitative evaluation of advanced laparoscopic viewing technologies. Surg Endosc 13:751–755PubMedCrossRefGoogle Scholar
  21. 21.
    Jones DB, Brewer JD, Soper NJ (1996) The influence of three-dimensional video systems on laparoscopic task performance. Surg Laparosc Endosc 6:191–197PubMedCrossRefGoogle Scholar
  22. 22.
    McDougall EM, Soble JJ, Wolf JS Jr, Nakada SY, Elashry OM, Clayman RV (1996) Comparison of three-dimensional and two-dimensional laparoscopic video systems. J Endourol 10:371–374PubMedCrossRefGoogle Scholar
  23. 23.
    Peitgen K, Walz MV, Walz MV, Holtmann G, Eigler FW (1996) A prospective randomized experimental evaluation of three-dimensional imaging in laparoscopy. Gastrointest Endosc 44:262–267PubMedCrossRefGoogle Scholar
  24. 24.
    Pietrabissa A, Scarcello E, Carobbi A, Mosca F (1994) Three-dimensional versus two-dimensional video system for the trained endoscopic surgeon and the beginner. Endosc Surg Allied Technol 2:315–317PubMedGoogle Scholar
  25. 25.
    Taffinder N, Smith SG, Huber J, Russell RC, Darzi A (1999) The effect of a second-generation 3D endoscope on the laparoscopic precision of novices and experienced surgeons. Surg Endosc 13:1087–1092PubMedCrossRefGoogle Scholar
  26. 26.
    Tevaearai HT, Mueller XM, von Segesser LK (2000) 3-D vision improves performance in a pelvic trainer. Endoscopy 32:464–468PubMedCrossRefGoogle Scholar
  27. 27.
    Thomsen MN, Lang RD (2004) An experimental comparison of 3-dimensional and 2-dimensional endoscopic systems in a model. Arthroscopy 20:419–423PubMedCrossRefGoogle Scholar
  28. 28.
    van Bergen P, Kunert W, Bessell J, Buess GF (1998) Comparative study of two-dimensional and three-dimensional vision systems for minimally invasive surgery. Surg Endosc 12:948–954PubMedCrossRefGoogle Scholar
  29. 29.
    Votanopoulos K, Brunicardi FC, Thornby J, Bellows CF (2008) Impact of three-dimensional vision in laparoscopic training. World J Surg 32:110–118PubMedCrossRefGoogle Scholar
  30. 30.
    Badani KK, Bhandari A, Tewari A, Menon M (2005) Comparison of two-dimensional and three-dimensional suturing: Is there a difference in a robotic surgery setting? J Endourol 19:1212–1215PubMedCrossRefGoogle Scholar
  31. 31.
    Blavier A, Gaudissart Q, Cadiere GB, Nyssen AS (2006) Impact of 2D and 3D vision on performance of novice subjects using da Vinci robotic system. Acta Chir Belg 106:662–664PubMedGoogle Scholar
  32. 32.
    Blavier A, Gaudissart Q, Cadiere GB, Nyssen AS (2007) Comparison of learning curves and skill transfer between classical and robotic laparoscopy according to the viewing conditions: implications for training. Am J Surg 194:115–121PubMedCrossRefGoogle Scholar
  33. 33.
    Falk V, Mintz D, Grunenfelder J, Fann JI, Burdon TA (2001) Influence of three-dimensional vision on surgical telemanipulator performance. Surg Endosc 15:1282–1288PubMedCrossRefGoogle Scholar
  34. 34.
    Hubens G, Coveliers H, Balliu L, Ruppert M, Vaneerdeweg W (2003) A performance study comparing manual and robotically assisted laparoscopic surgery using the da Vinci system. Surg Endosc 17:1595–1599PubMedCrossRefGoogle Scholar
  35. 35.
    Jourdan IC, Dutson E, Garcia A, Vleugels T, Leroy J, Mutter D, Marescaux J (2004) Stereoscopic vision provides a significant advantage for precision robotic laparoscopy. Br J Surg 91:879–885PubMedCrossRefGoogle Scholar
  36. 36.
    LaGrange CA, Clark CJ, Gerber EW, Strup SE (2008) Evaluation of three laparoscopic modalities: robotics versus three-dimensional vision laparoscopy versus standard laparoscopy. J Endourol 22:511–516PubMedCrossRefGoogle Scholar
  37. 37.
    Moorthy K, Munz Y, Dosis A, Hernandez J, Martin S, Bello F, Rockall T, Darzi A (2004) Dexterity enhancement with robotic surgery. Surg Endosc 18:790–795PubMedGoogle Scholar
  38. 38.
    Munz Y, Moorthy K, Dosis A, Hernandez JD, Bann S, Bello F, Martin S, Darzi A, Rockall T (2004) The benefits of stereoscopic vision in robotic-assisted performance on bench models. Surg Endosc 18:611–616PubMedCrossRefGoogle Scholar
  39. 39.
    Mueller MD, Camartin C, Dreher E, Hanggi W (1999) Three-dimensional laparoscopy: gadget or progress? A randomized trial on the efficacy of three-dimensional laparoscopy. Surg Endosc 13:469–472PubMedCrossRefGoogle Scholar
  40. 40.
    Patel HR, Ribal MJ, Arya M, Nauth-Misir R, Joseph JV (2007) Is it worth revisiting laparoscopic three-dimensional visualization? A validated assessment. Urology 70:47–49PubMedCrossRefGoogle Scholar
  41. 41.
    Hasson HM, Jason H (2007) Information retention and skill acquisition after CME meetings. Laparosc Today 6:4–6Google Scholar
  42. 42.
    Vickers AJ, Savage CJ, Hruza M, Tuerk I, Koenig P, Martinez-Pineiro L, Janetschek G, Guillonneau B (2009) The surgical learning curve for laparoscopic radical prostatectomy: a retrospective cohort study. Lancet Oncol 10:475–480PubMedCrossRefGoogle Scholar

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

Personalised recommendations