Technology and EngineeringThree-dimensional vs Standard Laparoscopy: Comparative Assessment Using a Validated Program for Laparoscopic Urologic Skills
Section snippets
Participants and Setting
The present study was carried out at the Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, during the 4th Minimally Invasive Urological Surgical Week annual course in Braga, Portugal in April 2013. Faculty members and course participants agreed to participate and were included in the study. Each participant was asked to complete standardized tasks in the dry laboratory, using both 2D and 3D systems. A computer-generated randomization sequence was used
Results
Overall, 33 urologic surgeons participated in the study, including 10 “experts” (median age 45 years; interquartile range [IQR] 38-54) and 23 “laparoscopy-naïve” residents (median age 27 years; IQR 25-28; P = 0.001). Most of the participants worked in a teaching hospital (29 of 33; 87.8%).
Table 1 summarizes the overall time used to complete the task and number of errors using 2D or 3D system. The use of 3D was associated with a faster (median 1115 [IQR: 596-1469] vs 1299 [IQR: 620-1723]
Comment
Despite its increasing adoption in urology over the last 2 decades, it is well established that laparoscopy carries intrinsic limitations, including reduced depth perception of the operative field caused by the use of 2D monitors, poor hand-eye coordination as a result of location of the monitor, variable amplification, and mirrored movement, and reduced haptic feedback from the use of long surgical instruments.
To partially overcome these challenges, recent technological advances allowed the
Conclusion
The latest generation of 3D imaging for laparoscopy seems to facilitate surgical performance of urologic surgeons without laparoscopic background. For those with established laparoscopic background, the advantage provided by the use of 3D remains to be determined. Further studies with larger sample size are needed to determine the actual effect of using 3D laparoscopy in the clinical setting.
Acknowledgments
The authors thank the 4th Minimally Invasive Urological Surgical Week course attendees who participated in this study. They also thank The Research Endoscopic Laboratory at the University of Minho and the support of Karl Storz, Germany for providing instrumentation used in the study.
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Financial Disclosure: The authors declare that they have no relevant financial interests.