The learning effect of using stereoscopic vision in the early phase of laparoscopic surgical training for novices

Abstract

BackgroundRecently to improve depth perception, the performance of three-dimensional (3D) laparoscopic surgeries has increased. However, the effects of laparoscopic training using 3D are still unclear. This study aimed to clarify the effects of using a 3D monitor among novices in the early phase of training.MethodsParticipants were 40 novices who had never performed laparoscopic surgery (20 medical students and 20 junior residents). Three laparoscopic phantom tasks (task 1: touching markers on a flat disk with a rod; task 2: straight rod transfer through a single loop; and task 3: curved rod transfer through two loops) in the training box were performed ten times, respectively. Performances were recorded by an optical position tracker. The participants were randomly divided into two groups: one group performed each task five times initially under a 2D system (2D start group), and the other group performed each task five times under a 3D system (3D start group). Both groups then performed the same task five times. After the trial, we evaluated the performance scores (operative time, path length of forceps, and technical errors) and the learning curves for both groups.ResultsScores for all tasks performed under the 3D system were significantly better than scores for tasks using the 2D system. Scores for each task in the 2D start group improved after switching to the 3D system. However, scores for each task in the 3D start group were worse after switching to the 2D system, especially scores related to technical errors.ConclusionsThe stereoscopic vision improved laparoscopic surgical techniques of novices from the early phase of training. However, the performance of novices trained only by 3D worsened by changing to the 2D environment.

Staying in touch with reality: The importance of stereoscopic vision

“…6 Surveys among surgeons have shown a subjective decrease in cognitive workload during stereoscopic vision in comparison with monoscopic vision, but other studies also demonstrate improved objective parameters such as an increased efficiency and a reduction in the number of errors in simulated laparoscopic tasks. 7,8 Interestingly, in novice surgical trainees, task performance seems to be enhanced during the learning curve when the monoscopic view is switched to a stereoscopic view and diminished when the reverse is done, 9 an observation that is in line with the observations of Wainman et al…”

“…monoscopic view is switched to a stereoscopic view and diminished when the reverse is done, an observation that is in line with the observations of Wainman et al. One could raise the question, on the basis of the study results of Wainman et al, whether a stereoscopic view could compensate for a low visual spatial ability test score in laparoscopic tasks.…”

Laparoscopic skills training: the effects of viewing mode (2D vs. 3D) on skill acquisition and transfer

“…faster completion times and fewer errors) can be achieved when novices use a 3D viewing mode rather than a 2D display or viewing mode [6][7][8][9]. However, several studies identified that the superior skill acquisition associated with training in 3D was not reflected in subsequent performance during testing in 2D [7,[10][11][12]. Further, those trained in 2D performed at a superior level when subsequently tested in 3D [7,[10][11][12].…”

“…However, several studies identified that the superior skill acquisition associated with training in 3D was not reflected in subsequent performance during testing in 2D [7,[10][11][12]. Further, those trained in 2D performed at a superior level when subsequently tested in 3D [7,[10][11][12]. Such results have been interpreted as an indication of ineffective skill transfer from 3D to 2D, and effective or increased skill transfer from 2D to 3D [7,[10][11][12].…”

“…Further, those trained in 2D performed at a superior level when subsequently tested in 3D [7,[10][11][12]. Such results have been interpreted as an indication of ineffective skill transfer from 3D to 2D, and effective or increased skill transfer from 2D to 3D [7,[10][11][12]. If this interpretation is correct, it may be because 2D training forces trainees to attend to and rely upon secondary depth cues (e.g.…”