Can 3D Vision Improve Laparoscopic Performance in Box Simulation Training when Compared to Conventional 2D Vision?

Abstract

Introduction: Three-dimensional (3D) imaging systems have been introduced in laparoscopic surgery to facilitate binocular vision and dexterity to improve surgical performance and safety. Several studies have shown the benefits of 3D imaging in laparoscopy, but until now only a few studies have assessed the outcome by using objective variables. Box trainers are affordable alternatives to virtual laparoscopic surgical training, and the possibility of using real surgical instruments makes them more realistic to use. However, the data and feedback by a virtual simulator have not, until now, been able to assess. Simball Box®, equipped with G-coder sensors®, registers the instrument movements during training and gives the same feedback like a virtual simulator. Aim:The aim of this study was to objectively evaluate the laparoscopic performance in 3D compared to conventional 2D vision by using a box simulation trainer. Materials and methods:Thirty surgeons, residents and consultants, participated in the study. Eighteen had no, or minimal, laparoscopic experience (novices) whereas 12 were experts. They all performed three standard box training exercises (rope race, precision cutting, and basic suturing) in Simball Box. The participants were randomized and started with either 3D HD or traditional 2D HD cameras. The exercises were instructed and supervised. All instrument movements were registered. Variations in time, linear distance, average speed, and motion smoothness were analyzed. Results:The parameters time, distance, speed, and motion smoothness were significantly better when the 3D camera was used.Conclusion: All individuals of both subgroups achieved significantly higher speed and better motion smoothness when using 3D.

Visuospatial ability is associated to 2D laparoscopic simulator performance amongst surgical residents

“…The 2D video box trainer is similar to the setup used in standard laparoscopic surgery, and hence the difference in results between 2D and 3D simulators are interesting. Other studies comparing 3D simulators to 2D simulators have shown shortening of learning curves and improved results for box trainers and VR simulator with 3D [ [34] , [35] , [36] ]. No major difference has been shown between performance in 2D box trainers and 2D VR trainers amongst residents, apart from a small possible benefit of using real instruments in the box trainer [ 37 ].…”

Insight into the history and trends of surgical simulation training in education: A bibliometric analysis

“…This implies that researchers tended to integrate two or more techniques into a single system to establish a more effective method. The combination of different advanced methods could offset the weaknesses of a single technique, such as laparoscopic training integrated with 3D printing 21 , or VR 27 , 28 . After rigorous simulator training, trainees can better perform laparoscopic procedures in the operation room 29 .…”