Comparison of two-dimensional and three-dimensional suturing: is there a difference in a robotic surgery setting?

Area of Science:

• Surgical Technology
• Robotics in Medicine
• Surgical Simulation

Background:

• Robotic surgery offers advanced visualization capabilities, including three-dimensional (3D) viewing.
• The comparative benefits of 3D versus two-dimensional (2D) visualization during robotic surgical procedures, specifically for suturing tasks, require detailed evaluation.

Purpose of the Study:

• To compare the efficiency and accuracy of suturing drills performed in 2D versus 3D using the da Vinci surgical system.
• To determine if 3D visualization provides a significant advantage over 2D during robotic suturing.

Main Methods:

• Seven surgeons, with varying levels of robotic experience, completed 28 anastomotic suturing drills on the da Vinci robot.
• Drills were performed in both 2D and 3D modes in a blinded, randomized fashion, including interrupted and running closure techniques.
• Data collected included time to completion, perceived difficulty, and accuracy, with independent review for major errors.

Main Results:

• Suturing tasks were completed significantly faster in 3D (8.5 minutes) compared to 2D (13.1 minutes), representing a 65% improvement.
• Both experienced and novice surgeons demonstrated faster completion times in 3D for both drill types.
• Fewer major errors occurred during 3D performances (2) compared to 2D (5), indicating comparable or improved accuracy with 3D visualization.

Conclusions:

• Three-dimensional visualization in robotic surgery significantly enhances suturing efficiency and accuracy compared to 2D.
• The benefits of 3D viewing are immediate and applicable to surgeons of all experience levels.
• The study highlights the advantage of 3D for tasks like knot tying, suggesting broader implications for complex robotic procedures.