3D laparoscopy – does improved visualization decrease the learning curve among trainees in advanced procedures?

Kyle G Cologne, MD, Anthony J Senagore, MD

Keck School of Medicine of the University of Southern California

Objective of the technology or device: Complex laparoscopic surgery is difficult to master. This is made harder by the fact that one must interpret a 3 dimensional environment on a 2 dimensional viewing screen. It remains unclear exactly what effect the use of 3d technology has on the training of a surgeon. Our aim is to evaluate the effectiveness of 3d on learning and performing advanced laparoscopic tasks in the lab and in more complex laparoscopic cases to see what effect (if any) 3d has on the ability to learn laparoscopic surgery and shorten the learning curve.

Description of the technology and method of application : Junior surgical residents and medical students without significant laparoscopic experience (novices) are evaluated in the performance of a variety of tasks. Inanimate models are used to assess laparoscopic suturing and transfer of objects on a peg-board. Participants repeat the task using 2d and 3d cameras with standard laparoscopic instruments (3DHD by Viking Systems©). Time and error rates (including missed attempts, dropped objects, and failure to complete the task) are calculated and scored. Surgical procedures performed by residents are evaluated by a 3rd party viewing a videotape of the procedure (who is blinded to whether it was performed in 2d or 3d). This reviewer will again evaluate error rates and efficiency of performing pre-defined steps of the procedure. Survey results regarding the overall impression of the technology’s impact on performance are also tabulated.

Preliminary Results: Preliminary data demonstrate a 50% decrease in the time to complete the task among novice providers when using 3d. This also has crossover effects when performing subsequent tasks in 2d, as students have gained some spacial orientation. More complex tasks (intracorporeal suture, peg transfer) were associated with a greater improvement in speed than simple tasks.

Conclusions: Early results indicate that 3d significantly improves visualization and ability to perform complex tasks. It is likely that 3d technology is very effective at shortening the learning curve to train surgeons in advanced laparoscopy – a very important factor in the era of work hour restrictions.

Session: Poster Presentation

Program Number: ETP080

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