The effect of a second-generation 3D endoscope on the laparoscopic precision of novices and experienced surgeons

Taffinder, N; Smith, Simon; Huber, Joerg W.; Russell, R. C. G.; Darzi, Ara

doi:10.1007/s004649901179

Cited by 212 publications

(160 citation statements)

References 16 publications

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“…It was also the only determinant factor for performance in the first and easiest task. These findings confirm the important impact of binocular depth perception on surgical performance [1,8,19,25,26].…”

Section: Tasks Of Increasing Complexitysupporting

confidence: 82%

“…In laparoscopic surgery, new systems allow the use of two-(2D) or three-dimensional (3D) vision. However, the literature reports contradictory results concerning the benefits of 3D vision: some studies show that better motor performances are obtained with 3D vision [1,8,19,25,26] while others fail to reveal any difference in performance between 2D and 3D vision [5, 6, 12, 20]. In some studies [5], only complex tasks were performed faster and more easily with a 3D view whereas no difference between the use of 2D and 3D views appeared when performing the easiest tasks.…”

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confidence: 99%

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Perceptual and instrumental impacts of robotic laparoscopy on surgical performance

et al. 2007

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New technologies in surgery are in constant and considerable evolution; they transform the surgeonÕs activity and practice. In laparoscopic surgery, new systems allow the use of two-(2D) or three-dimensional (3D) vision. However, the literature reports contradictory results concerning the benefits of 3D vision: some studies show that better motor performances are obtained with 3D vision [1,8,19,25,26] while others fail to reveal any difference in performance between 2D and 3D vision [5, 6, 12, 20]. In some studies [5], only complex tasks were performed faster and more easily with a 3D view whereas no difference between the use of 2D and 3D views appeared when performing the easiest tasks. The divergence in these results is partially due to the fact that first-generation 3D systems, with their lower resolution, were compared with standard 2D systems [10]. Nowadays, new 3D systems allow a natural bidimensional view and thus suppress the bias observed in previous studies.In this paper, we used a new-generation 3D system, the da Vinci robotic system. This robotic system allows a 3D visualization of the operative field to be gained, restores the degrees of freedom (DOFs) lost in classical laparoscopy, and improves the dexterity of the surgeonÕs hand and wrist. Only one published study [13] has compared the performance obtained using classical laparoscopic techniques and those using this robotic system. This study revealed advantages of the da Vinci robotic system, particularly when it was used with the 3D view option. However, only six subjects participated in this study and the chosen tasks were very specific to the robotic system training.Our objective was therefore to study, with more participants, the impact of the da Vinci robotic system on standard and ecological surgical tasks of increasing complexity (ecological in the sense that our tasks were similar to the gestures made by the surgeon in a real situation, for which we used bench models developed and validated in several studies [7,22,23]). To analyse the nature of the benefits brought about by these expensive new technologies precisely, we independently differentiated and studied the influence of the 3D view (afferent component), comparing 2D and 3D view, and the influence of movement freedom restauration (DOFs, efferent component), comparing the classical laparoscopy with the robotic system.We also studied the impact of the use of the robotic technology on the subjectÕs self-confidence, satisfaction and facility, knowing that these three factors influence both the performance and acceptance of new technology in the operating room [16,17]. To avoid any bias from earlier laparoscopic experience in our comparison between classical and robotic laparoscopic techniques, we only selected medical students without any prior experience in open, minimally invasive or robotically assisted surgery. Materials and methods MaterialsThe da Vinci system consists of two primary components: the surgeonÕs viewing and control console and, a moveable cart with three articulate...

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Section: Tasks Of Increasing Complexitysupporting

confidence: 82%

mentioning

confidence: 99%

Perceptual and instrumental impacts of robotic laparoscopy on surgical performance

et al. 2007

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“…Although some have reported that 3D imaging significantly improves performance, [2][3][4][5][6][7][8][9][10] others have claimed equivalency in task performance between 2D and 3D vision. 1,11,12 It is important that considerable technical advances have been made in the design of high-definition stereoscopic 3D visualization systems since the publication of these earlier studies.…”

Section: Introductionmentioning

confidence: 99%

2D Versus 3D Visualization: Impact on Laparoscopic Proficiency Using the Fundamentals of Laparoscopic Surgery Skill Set

Tanagho

Andriole

Paradis

et al. 2012

Journal of Laparoendoscopic & Advanced Surgical Techniques

158

105

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Introduction: We compared the impact of two-dimensional (2D) versus three-dimensional (3D) visualization on both objective and subjective measures of laparoscopic performance using the validated Fundamentals of Laparoscopic Surgery (FLS) skill set. Subjects and Methods: Thirty-three individuals with varying laparoscopic experience completed three essential drills from the FLS skill set (peg transfer, pattern cutting, and suturing/knot tying) in both 2D and 3D. Participants were randomized to begin all tasks in either 2D or 3D. Time to completion and number of attempts required to achieve proficiency were measured for each task. Errors were also noted. Participants completed questionnaires evaluating their experiences with both visual modalities. Results: Across all tasks, greater speed was achieved in 3D versus 2D: peg transfer, 183.4 versus 245.6 seconds (P < .0001); pattern cutting, 167.7 versus 209.3 seconds (P = .004); and suturing/knot tying, 255.2 versus 329.5 seconds (P = .031). Fewer errors were committed in the peg transfer task in 3D versus 2D (P = .008). Fourteen participants required multiple attempts to achieve proficiency in one or more tasks in 2D, compared with 7 in 3D. Subjective measures of efficiency and accuracy also favored 3D visualization. The advantage of 3D vision persisted independent of participants' level of technical expertise (novice versus intermediate/expert). There were no differences in reported side effects between the two visual modalities. Overall, 87.9% of participants preferred 3D visualization. Conclusions: Three-dimensional vision appears to greatly enhance laparoscopic proficiency based on objective and subjective measures. In our experience, 3D visualization produced no more eye strain, headaches, or other side effects than 2D visualization. Participants overwhelmingly preferred 3D visualization.

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“…In fact current endoscopic technology offers excellent resolution (high-definition [HD] cameras) but creates a two-dimensional (2-D) image that impairs depth perception and hand-eye coordination, and reduces the ability to estimate size. 7 To gain a depth cue in such a 2-D environment, surgeons seek sensorial and tactile feedback during manipulation of instruments by constantly moving the scopes in and out or from side to side. In this manner, depth perception is based on integration of indirect information from a variety of sources, including the surgeon's former knowledge of the spatial relationship between anatomical structures.…”

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confidence: 99%

Transnasal Skull Base Reconstruction Using a 3-D Endoscope: Our First Impressions

et al. 2012

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Endoscopic endonasal duraplasty has been demonstrated to be an effective, safe, and reliable approach in most cases of skull base defects, regardless of the size. [1][2][3][4][5][6] One of the primary restrictions of the endoscopic technique, however, in contrast with microscopic procedures, is the lack of binocular vision and consequently of third dimension. In fact current endoscopic technology offers excellent resolution (high-definition [HD] cameras) but creates a two-dimensional (2-D) image that impairs depth perception and hand-eye coordination, and reduces the ability to estimate size. 7 To gain a depth cue in such a 2-D environment, surgeons seek sensorial and tactile feedback during manipulation of instruments by constantly moving the scopes in and out or from side to side. In this manner, depth perception is based on integration of indirect information from a variety of sources, including the surgeon's former knowledge of the spatial relationship between anatomical structures. 8 Recently introduced HD stereoscopes produce a threedimensional (3-D) image of the surgical field, with natural binocular ability to perceive depth, volume, and distance accurately. 9 Although in preliminary series, stereoscopic skull base surgery has proved to be a feasible and safe procedure, with outcomes comparable to those achieved with standard 2-D endoscopes. 10,11 Moreover, earlier task-based simulator studies have shown the benefit of 3-D technology in terms of speed, efficiency, and error rates when compared with the 2-D technique. 12 Thus, on the basis of these considerations and our large skull base reconstruction experience (more than 400 cases), we have begun to use 3-D endoscope in endonasal endoscopic procedures. Accordingly, in this study we report our preliminary impressions about the application of a novel 3-D endoscopic system in the field of skull base AbstractNowadays endoscopic skull base reconstruction is safely and effectively performed by means of two-dimensional (2-D) endoscopic technique. The aim of our study is to compare our 2-D experience with the novel 3-D technology in the field of skull base reconstruction techniques. In this study four patients treated with various kinds of planned duraplasty are included. The new 3-D technology was compared with the highdefinition 2-D scopes during the different steps of the procedures. The 3-D endoscopic skull base reconstruction obtained primary closure without complications in all cases. According to the subjective opinion of experienced endosurgeons, this novel technique improved depth perception, distance and size estimation, ability to identify specific anatomic structures, and hand-eye coordination. The main drawbacks detected were inferior sharpness, contrast and lighting that impaired the application of the technique in narrow sinonasal spaces. According to our preliminary impressions, 3-D endoscopic skull base reconstruction is an effective and safe procedure and could represent a significant advantage for accurate managing of the skull base region.

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The effect of a second-generation 3D endoscope on the laparoscopic precision of novices and experienced surgeons

Abstract: Second-generation 3D significantly improved the laparoscopic precision of novices and experienced surgeons, without the side effects reported from previous systems. This technology is expected to improve the ease and safety of laparoscopic surgery.

Cited by 212 publications

References 16 publications

Perceptual and instrumental impacts of robotic laparoscopy on surgical performance

Perceptual and instrumental impacts of robotic laparoscopy on surgical performance

2D Versus 3D Visualization: Impact on Laparoscopic Proficiency Using the Fundamentals of Laparoscopic Surgery Skill Set

Transnasal Skull Base Reconstruction Using a 3-D Endoscope: Our First Impressions

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