Evaluation of eye & hand fatigue in 3D vs. 2D display systems for surgical novices during laparoscopic suturing; a Randomised Control Trial

Adham Youssef, Walid Elbakbak, Amina Bouhelal, Bijen Patel. Queen Mary, University of London.

The available data reports the efficacy of the 3D vision system and its superiority to 2D. However the physiological effect of 3D on surgeons remains unaddressed.
We aimed to objectively investigate the effect of 3D on ocular and hand muscles fatigue in comparison to 2D and its impact on surgical performance in novices.

We conducted a stratified randomised comparative study with cross-over of 13 novices. Eye fatigue assessed using Visual Stress Test (VST), Visual Acuity (VA) and post-study display questionnaire. Hand fatigue was assessed using grip dynamometer (GD). Surgical performance was evaluated using a validate curriculum with proficiency criteria; the Fundamentals of Laparoscopic Surgery curriculum.

The VST showed a higher mean score in the 3D group of 3.92 in comparison to the 2D group with mean of 3.15, (P-value = 0.23). It is apparent from VA test that the 3D group had a better VA on both eyes compared to the 2D group after performing the suturing task (right eye; P-value=0.29, left eye P-value=0.47). There was no statistical difference in handgrip strength between both display groups (right hand; P-value=0.55, left hand P-value=0.70). The 3D group demonstrated statistically evident superior performance in terms of less slippage errors (P-value=0.003) and gap errors (P-value=0.015), number of repetitions and accuracy were similar in both groups (P-value=0.81 and P-value=0.20 respectively).

3D offers superior visual feedback that positively reflects on the VA and accuracy which in turn favourably impact training and patient safety.

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