Simulation of Single Port Endoscopic Surgery: Comparative Study of Two- with Three-dimensional Video System

Kook Nam Han, MD, PhD, Hyun Koo Kim, MD, PhD, Hyun Joo Lee, RN, Young Ho Choi, MD, PhD. Korea University Guro Hospital, Korean University College of Medicine

INTRODUCTION – Usual video systems for endoscopic surgery provide the surgeon a two-dimensional image (2D). This study aimed to evaluate performances of a three-dimensional (3D) video system compared with 2D system on the simulation for single-port surgery training.

METHODS AND PROCEDURES – We conducted a simulation program for single port endoscopic surgery using 2D and 3D high definition system. The program included three basic surgical tasks; 1) ring transfer, 2) needle passing through 3-mm hole, 3) suturing through tailor-made skin suturing plate, through 3-cm single port training module (Fig.1). We evaluated the time to completion and success or failure within limited time in each tasks.

RESULTS – 19 trainee who had not experienced endoscopic or robotic surgery, performed three simulation tasks under 2D and 3D system respectively. 18 participants (94.7%) in task 1 and 2, 14 (73.7%) in task 3, showed improved performance and spent less time to complete the tasks using 3D system (Fig.2). On post-surveillances, trainee indicated that the advantages of 3D system compared to 2D was easier depth perception of structures (n=11, 57.9%), improved handling of instruments (n=8, 42.1%). All participants were not disturbed by wearing glasses for 3D vision or had not felt severe eye discomfort during the simulation.

CONCLUSIONS – Three-dimensional video system showed improved procedural time and better performance compared to two-dimensional system during simulation for single port endoscopic surgery. It should facillitate the single port surgery to enable more complex procedures and could help to expand the users interested in single port surgery.


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