Hitoshi Harada, MD, Shingo Kanaji, MD, PhD, Masayasu Nishi, MD, Hiroshi Hasegawa, MD, PhD, Masashi Yamamoto, MD, PhD, Yoshiko Matsuda, MD, PhD, Kimihiro Yamashita, MD, PhD, Takeru Matsuda, MD, PhD, Taro Oshikiri, MD, PhD, Tetsu Nakamura, MD, PhD, Yasuo Sumi, MD, PhD, Satoshi Suzuki, MD, PhD, Yoshihiro Kakeji, MD, PhD. Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine
INTRODUCTION: In recently, the number of three-dimensional (3D) laparoscopic surgeries has increased. However, the effects of 3D images to early experience of novices is controversial. The aim of this study is to clarify the effect of stereoscopic images from using a 3D monitor to laparoscopic surgical training for novices.
METHODS AND PROCEDURES: The participants in this study were 40 novices who had never performed laparoscopic surgery as an operator (20 medical students and 20 junior residents). Different three laparoscopic phantom tasks (task 1: touching markers on the flat disc with a rod, task 2: straight rod transfer through single loop, task 3: curved rod transfer through two loops) in the training box were performed five times each (as one set) and their performances were recorded by optical position tracker in order to analyze the motion of forceps in 3D space. The participants were randomly divided into two groups: one group carried out a set of tasks initially under a 2D system, and the other group under a 3D system. Both groups performed the same set of tasks again after switching another system. After the second set of tasks was finished, we compared operation time, path lengths of forceps, and technical errors under both 3D and 2D systems in all tasks. In addition, we also investigated the learning curves of each group through all attempts.
RESULTS: In comparison between 2D and 3D, mean operation times (sec) were 25.6, 22.3 (P=0.03) in task 1, 28.0, 21.1 (P<0.001) in task 2, and 42.8, 37.2 (P=0.015) in task 3. Mean path lengths (mm) were 1456, 1337 (P=0.054) in task 1, 1308, 1020 (P<0.001) in task 2, and 2016, 1797 (P=0.019) in task 3. Mean technical errors (times) were 1.4, 0.9 (P=0.021) in task 1, 3.1, 1.2(P<0.001) in task 2, and 10.8, 7.3 (P<0.001) in task 3. Each score of all tasks performed under the 3D was significantly better compared to the 2D system. The learning curves showed that each score of the group initially using a 2D system was improved after switching to 3D system. However, each score of the group initially using a 3D system was worse after switching to 2D system.
CONCLUSIONS: The stereoscopic images improves laparoscopic surgical techniques of novices. However, novices relying on a 3D system may lose the advantage of experience from stereoscopic images after switching to a 2D system.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78705
Program Number: P307
Presentation Session: Poster (Non CME)
Presentation Type: Poster
