In recent years, endoscopic operations have become standard surgical methods [1]. One of the problems of endoscopic surgery is the monitoring of images obtained by the optical scope. The operator has to observe the fixed monitor in an unnatural posture and perform surgical manipulations based on two-dimensional images. These problems hinder safe and rapid endoscopic surgery. To solve these problems, we developed a threedimensional monitor unit that integrates the operator. Device descriptionHumans recognize an object as a stereoscopic image by observing it with two eyes at a visual angle. The optical scope (A4863, Olympus, Tokyo) has two CCD cameras in the scope head, and separate outputs by each CCD camera is possible. The CCD camera image on the right side obtained by this optical scope is projected on the right eye, and that on the left side is projected on the left eye, which allows recognition of physiological stereoscopic images by the operator, thus allowing stereoscopic vision. For the independent recognition of the right or left images by the right or left eye, respectively, a unit containing mirrors was constructed, and 8-in. liquid crystal displays (TlexView 81A, Eizo Nanao, Ishikawa, Japan) were placed on to the unit (Fig. 1A). In addition, the unit was fixed with a flexible arm extending from the back of the operator so that the operator can adjust it to his or her posture (Fig. 1B). Although 8-in. liquid crystal displays are used, by calculation, the operator recognizes the images as 80-in. displays 3 m ahead of him or her. MethodsThe usefulness of this monitor unit was evaluated in terms of the time required for thread ligation using forceps by five surgeons under endoscopic guidance. Each surgeon ligated thread five times each using a conventional two-dimensional monitor and our three-dimensional monitor, and the mean time was calculated. ResultsThe time required for ligation (mean ± SD) was 23.28 ± 6.45 sec using the two-dimensional monitor and 19.88 ± 6.06 sec using the three-dimensional monitor (p = 0.07). The operators reported that the floating thread could be very easily caught using the threedimensional monitor, and that the monitor is useful. DiscussionCurrentry, operators must observe a fixed monitor and perform surgery based on two-dimensional images. To simultaneously solve these problems of endoscopic surgery, we developed a three-dimensional monitor unit that integrates the operator. This monitor unit provides excellent three-dimensional images, and our experiments indicated the usefulness of this monitor unit, although no significant difference was observed in the results. The indications for endoscopic surgery are expected to further expand. Off-pump endoscopic coronary bypass operation has been also reported [2], and this monitor unit may be particularly useful for fine manipulations, such as vascular anastomosis and dissection of adhesion. We also used this monitor unit in endoscopic mediastinal tumor resection (Fig. 2) and found it to be very useful for dissection of adhesion and...

No abstract

Orthopaedic HospitalThirty cases with fractures of the Distal end of the tibia were treated. Radiographic results were eusluated as anatomical in 20 cases, fair in 7 and poor in 3. Subjective results were judged to be good in 23 cases, fair in 4 and poor in 3. Anatomical results were related to subjective results.Accurate reduction and internal fixation following the four principles of AO group sufficient to allow early mobihzation are important for good treatment results.