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Three-dimensional imaging improved the laparoscopic performance of inexperienced operators: a prospective trial

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Abstract

Background

Three-dimensional (3-D) high-definition (HD) stereovision and two-dimensional (2-D) ultra-high-resolution (4K) monitors have recently become available for laparoscopic surgery. The aim of this study was to compare laparoscopic performance between inexperienced participants using 3-D/HD and 2-D/4K monitors and those using conventional 2-D/HD monitors.

Methods

The study enrolled 66 participants with no previous surgical experience or medical training. They were randomly divided into three equal groups, each using a different type of monitor (2-D/HD, 2-D/4K, or 3-D/HD), to perform three phantom tasks using a laparoscopic simulator: Task 1, touching markers on a non-flat surface; Task 2, bimanual peg transfer; and Task 3, passing a straight rod through a loop. Each task was performed three times. The performance scores (operative time, path length of the forceps, and technical errors) were compared for each monitor type and by age group (< 30 vs. > 30 years).

Results

For all three tasks, scores using the 3-D monitor were significantly better than those using either 2-D monitor, with no difference between the 2-D/4K and 2-D/HD monitors. Using the 2-D monitors, the performance of Task 3 by the participants > 30 years was worse than that by the younger participants; however, there was no difference between the age groups when using the 3-D monitor.

Conclusion

Participants with no prior experience using a 3-D monitor showed better laparoscopic performance than those using 2-D monitors, even with 4K resolution. This improvement was more marked in older participants, suggesting a greater loss of depth perception in a 2-D environment.

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References

  1. Harada H, Kanaji S, Nishi M, Otake Y, Hasegawa H, Yamamoto M, Matsuda Y, Yamashita K, Matsuda T, Oshikiri T, Sumi Y, Nakamura T, Suzuki S, Sato Y, Kakeji Y (2018) The learning effect of using stereoscopic vision in the early phase of laparoscopic surgical training for novices. Surg Endosc 32:582–588

    Article  Google Scholar 

  2. Nishi M, Kanaji S, Otake Y, Harada H, Yamamoto M, Oshikiri T, Nakamura T, Suzuki S, Suzuki Y, Hiasa Y, Sato Y, Kakeji Y (2017) Quantitative comparison of operative skill using 2- and 3-dimensional monitors during laparoscopic phantom tasks. Surgery 161:1334–1340

    Article  Google Scholar 

  3. Harada H, Kanaji S, Hasegawa H, Yamamoto M, Matsuda Y, Yamashita K, Matsuda T, Oshikiri T, Sumi Y, Nakamura T, Suzuki S, Kakeji Y (2018) The effect on surgical skills of expert surgeons using 3D/HD and 2D/4K resolution monitors in laparoscopic phantom tasks. Surg Endosc 32:4228–4234

    Article  Google Scholar 

  4. Abdelrahman M, Belramman A, Salem R, Patel B (2018) Acquiring basic and advanced laparoscopic skills in novices using two-dimensional (2D), three-dimensional (3D) and ultra-high definition (4K) vision systems: a randomized control study. Int J Surg 53:333–338

    Article  CAS  Google Scholar 

  5. Chiu CJ, Prabhu KL, Tan-Tam CC, Panton ON, Meneghetti A (2015) Using three-dimensional laparoscopy as a novel training tool for novice trainees compared with two-dimensional laparoscopy. Am J Surg 209:824–827

    Article  Google Scholar 

  6. Egi H, Hattori M, Suzuki T, Sawada H, Kurita Y, Ohdan H (2016) The usefulness of 3-dimensional endoscope systems in endoscopic surgery. Surg Endosc 10:4562–4568

    Article  Google Scholar 

  7. Poudel S, Kurashima Y, Watanabe Y, Ebihara Y, Tamoto E, Murakami S, Nakamura T, Tsuchikawa T, Okamura K, Shichinohe T, Hirano S (2017) Impact of 3D in the training of basic laparoscopic skills and its transferability to 2D environment: a prospective randomized controlled trial. Surg Endosc 31:1111–1118

    Article  Google Scholar 

  8. Arezzo A, Vettoretto N, Francis NK, Bonino MA, Curtis NJ, Amparore D, Arolfo S, Barberio M, Boni L, Brodie R, Bouvy N, Cassinotti E, Carus T, Checcucci E, Custers P, Diana M, Jansen M, Jaspers J, Marom G, Momose K, Müller-Stich BP, Nakajima K, Nickel F, Perretta S, Porpiglia F, Sánchez-Margallo F, Sánchez-Margallo JA, Schijven M, Silecchia G, Passera R, Mintz Y (2019) The use of 3D laparoscopic imaging systems in surgery: EAES consensus development conference 2018. Surg Endosc 33:3251–3274

    Article  Google Scholar 

  9. Zhou J, Xu HJ, Liang CZ, Zhang L, Hao ZY, Feng LX (2015) A comparative study of distinct ocular symptoms after performing laparoscopic surgical tasks using a three-dimensional surgical imaging system and a conventional two-dimensional surgical imaging system. J Endourol 29:816–820

    Article  Google Scholar 

  10. Schiller PH, Kendall GL, Kwak MC, Slocum WM (2012) Depth perception, binocular integration and hand-eye coordination in intact and stereo impaired human subjects. J Clin Exp Ophthalmol 3:210

    Article  Google Scholar 

  11. Bosten JM, Goodbourn PT, Lawrance-Owen AJ, Bargary G, Hogg RE, Mollon JD (2015) A population study of binocular function. Vis Res 110:34–50

    Article  CAS  Google Scholar 

  12. Fergo C, Burcharth J, Pommergaard HC, Rosenberg J (2016) Age is highly associated with stereo blindness among surgeons: a cross-sectional study. Surg Endosc 30:4889–4894

    Article  Google Scholar 

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Acknowledgments

The authors would like to thank the staff at IRCAD and other volunteers who participated in this study. Medical English proofreading by Iana Shutrova has been a valuable help with the manuscript revision. We would also like to thank Olympus Corporation Europe for kindly lending us the 3-D/HD and 2-D/4K laparoscopic systems for the purposes of this study.

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Authors and Affiliations

  1. IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France

    Shingo Kanaji, Ryohei Watanabe, Silvana Perretta, Bernard Dallemagne & Jacques Marescaux

  2. IHU-Strasbourg, Institute of Image‐Guided Surgery, Strasbourg, France

    Pietro Mascagni, Fabian Trauzettel, Takeshi Urade, Fabio Longo, Ludovica Guerriero, Silvana Perretta, Bernard Dallemagne & Jacques Marescaux

  3. Department of General, Digestive, and Endocrine Surgery, University of Strasbourg, Strasbourg, France

    Silvana Perretta & Bernard Dallemagne

  4. Centre for Endoscopic Research Therapeutics and Training, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

    Pietro Mascagni

  5. Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan

    Shingo Kanaji & Yoshihiro Kakeji

Authors
  1. Shingo Kanaji
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  2. Ryohei Watanabe
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  3. Pietro Mascagni
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  7. Ludovica Guerriero
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  8. Silvana Perretta
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  10. Yoshihiro Kakeji
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  11. Jacques Marescaux
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Corresponding author

Correspondence to Shingo Kanaji.

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Disclosures

Jacques Marescaux is the President of both IRCAD and IHU Institutes, which are partly funded by KARL STORZ, Medtronic, and Siemens Healthcare. Shingo Kanaji, Ryohei Watanabe, Pietro Mascagni, Fabian Trauzettel, Takeshi Urade, Fabio Longo, Ludovica Guerriero, Silvana Perretta, Bernard Dallemagne, and Yoshihiro Kakeji have no conflict of interest or financial ties to disclose.

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Kanaji, S., Watanabe, R., Mascagni, P. et al. Three-dimensional imaging improved the laparoscopic performance of inexperienced operators: a prospective trial. Surg Endosc 34, 5083–5091 (2020). https://doi.org/10.1007/s00464-019-07308-6

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  • DOI: https://doi.org/10.1007/s00464-019-07308-6

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