Steven D Kim, BS1, Audriene May, MS1, Heidi Ryan, MD2, Adnan Mohsin, BS1, Shawn Tsuda, MD2. 1University of Nevada, Reno School of Medicine, 2University of Nevada, Las Vegas School of Medicine
Introduction: Studies have shown that using robotic-assisted laparoscopy (RL) increases performance compared to conventional laparoscopy (CL) due to its mechanical advantages but have not assessed distraction as a factor. To determine whether the immersive aspect of the 3D optics in RL contributes to improved performance, we compared the outcomes of laparoscopic skills by using the 3D optics of the da Vinci versus the conventional 2D monitor, with and without distraction.
Methods: Thirty-two participants without any laparoscopic experience were randomized evenly into four groups: RL (Group A), RL with distraction (Group B), CL (Group C), CL with distraction (Group D). Each participant performed three Fundamentals of Laparoscopy Surgery tasks (peg transfer [Task 1], circle cutting [Task 2], and suturing with knot [Task 3]) for three repetitions. For each task, the mean time and errors were recorded and analyzed statistically for each group.
Results: Comparted to other groups, Group D took on average one minute longer to complete Task 1 (P=0.001), more than one minute to complete Task 2 (P=0.003), and more than two minutes to complete Task 3 (P<0.001). On Task 2, the deviations from the pattern were shorter for Groups A and B compared to Groups C and D (mean 0.33 cm and 0.37cm vs. 0.55cm and 0.58cm, respectively; P<0.001). On Task 3, the deviations were also shorter for Groups A and B compared to Groups C and D (mean 0.23mm and 0.24mm vs. 0.61mm and 0.63mm, respectively; P< 0.001).
Conclusion: When distraction was introduced, Group D, the CL group, performed significantly worse. This suggests that using the conventional 2D monitor does not help with blocking out distraction. For Tasks 2 and 3, which require more precision and depth perception, the groups that used the 3D optics had shorter mean deviations than groups that used the conventional 2D monitor. This suggests that even when the robotic arms of the da Vinci are removed, there are still advantages to the immersive 3D optics, especially when distraction is present. The immersive aspect of the 3D optics may help improve performance in the OR, allowing surgeons to be more focused on the case and have greater depth acuity.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77533
Program Number: S067
Presentation Session: Robotics
Presentation Type: Podium