Per Holmström, MD1, Arestis Sokratous, MD1, Lars Enochsson, MD, PhD2, Evangelos Georgiou, MD, PhD3, Johanna Österberg, MD, PhD1. 1Department of Surgery, Mora Hospital, Mora, 2Department of Surgical and Perioperative Sciences, Umeå University, 3Medical Physics Lab-Simulation Center, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Introduction: 3D imaging systems have been introduced in laparoscopic surgery to facilitate the binocular vision and dexterity with the intention of improving surgical performance and safety. Several studies show the benefits of 3D imaging in laparoscopy but, until now, only a few studies have assessed the outcome by using objective variables. Box trainers are good and affordable alternatives to virtual laparoscopic surgical training, and the possibility of using real surgical instruments make them more realistic to use. However, until today, the data and feedback given by a virtual simulator have not been able to assess in a box trainer. Simball Box®, which is equipped with G-coder sensors®, registers all the instrument movements during training and gives the same feedback that a virtual simulator would.
The aim of this study is to objectively evaluate laparoscopic performance in 3D compared to conventional 2D vision by using a box simulation trainer.
Materials and Methods: Thirty surgeons, residents and consultants, participated in the study. 18 with none or minimal laparoscopic experience (non-experienced) and 12 doing laparoscopic surgery on a regular basis (experienced). They performed three standard box training exercises (rope race, precision cutting, and basic suturing) in Simball Box. The participants were randomized to start with either a 3D HD or traditional 2D HD camera. The exercises were instructed and supervised. All instrument movements were registered. Variations in time, linear distance, average speed, and motion smoothness were analyzed.
Results: Significant differences in the parameters, time (p <0.01), distance (p <0.05), speed (p <0.01), and motion smoothness (p <0.01) in favor of the 3D imaging system were found in all three exercises. In the subgroup analysis (non-experienced and experienced surgeons), the 3D imaging system significantly improved speed and motion smoothness in both groups.
Conclusion/Future direction: In this study, participants benefit by 3D technology implementation. Regardless of experience, 3D imaging improves surgical performance in both time and accuracy. Since 3D imaging systems most likely will be more common in the future an increasing need for black box training with 3D imaging systems during surgical residency can be anticipated.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 84428
Program Number: ETP750
Presentation Session: Emerging Technology Poster
Presentation Type: Poster