Laparoscopic Skills Acquisition Using Two Dimension and Three Dimension Visual Systems: A Randomized Control Study

Badriya S Alaraimi, MD, Shah-Jalal Sarker, PhD, Walid S ElBakbak, MSc, Ahmad Al-Marzouq, MSc, Sundus Makkiyah, MSc, Richie G. Goriparthi, MSc, Vincent Quan, BSc, Bijendra Patel, FRCS

Barts Cancer Institute, Queen Mary University of London and Barts and the London Hospitals

Objectives: To compare performance of novices on three dimension (3D) and two dimension (2D) vision systems using fundamentals of laparoscopic surgery (FLS) curriculum.

Methods: Forty medical students were randomised to 3D and 2D for acquiring laparoscopy skills using four FLS tasks on Laprotrain box trainer. The 3D technology used was passive polarization. Performance measured included completion time, number of repetitions and errors.Performace compared to the pre set proficency criteria by the FLS.

Data collected in excel sheets and analysed using Mann-Whitney u test via SPSS version 20.


FLS Task Total Time (minutes)
Median (IQR)
Total Repetitions
Median (IQR)
Total Errors
Median (IQR)
2D 3D 2D 3D 2D 3D
Peg transfer

108(27) 149(29)* 80(13) 80(0)* 11(10) 4(4)*
Endoloop 6(8) 5(5) 6(6) 6(4) 2(8) 2(4)
Extracorporeal suturing 48(27) 36(18) 13(6) 11(5) 44(44) 4(28)*
Intracorporeal suturing 73(46) 42(39) 19(12) 14(12) 28(32) 12(14)*

*Sig at 5% level, SD=Standard deviation, IQR=Interquartile range

The Median of the total number of repetitions and total time to complete curriculum was lower in 3D vs. 2D; 110 vs. 118(P=.29) and 3.7 vs. 4.0 hrs (P=.62) respectively. Median errors in 3D group 37 was less compared to 2D group 85 (P=.00).

Conclusion: 3D group performed better in more advanced tasks of the FLS with significant reduction in error scores. Performance time and repetitions were less in the 3D group although it’s not statistically significant and this was observed to be related to visual adaption time needed for the 3D group for each exercise and relatively flat field in box trainer with fewer points of reference for variable depth perception for 3D effect.The 3D technology still have more areas unexplored and needs further evaluation in real clinical settings with objective measures.

Session: Poster Presentation

Program Number: P151

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