Impact of Motorized Articulating Laparoscopic Devices with Three-Dimension Visualizing System: A Pilot Study

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Urologic Laparoscopy

Background:

• Laparoscopic surgery relies on instrument dexterity and visualization.
• Articulating instruments (AI) offer enhanced maneuverability over conventional laparoscopic instruments (CI).
• Three-dimensional (3D) visualization may improve depth perception compared to two-dimensional (2D) systems.

Purpose of the Study:

• To compare the efficacy of motorized articulating instruments (AI) versus rigid conventional laparoscopic instruments (CI).
• To evaluate the impact of two-dimensional (2D) versus three-dimensional (3D) visualization systems on surgical task performance.
• To assess these technologies across different experience levels in urologic laparoscopy.

Main Methods:

• Sixty physicians were stratified into three experience groups: students, residents, and expert surgeons.
• Participants performed standardized European training in basic laparoscopic urological skills (E-BLUS) and anastomosis tasks on four platforms: CI-2D, CI-3D, AI-2D, and AI-3D.
• Task duration, error counts, and completion quality were systematically recorded and evaluated.

Main Results:

• Expert surgeons (Group 3) consistently outperformed novice groups across all platforms, demonstrating significant time reduction and quality improvement (p < 0.001).
• The AI-3D system significantly enhanced task quality for novice surgeons (Groups 1 and 2) in all E-BLUS tasks.
• While expert surgeons showed improved performance with AI-3D, particularly in anastomosis, this did not reach statistical significance.

Conclusions:

• The AI-3D visualizing system offers superior performance in E-BLUS tasks for beginners in urologic laparoscopy compared to CI-2D, AI-2D, and CI-3D systems.
• Articulating instruments combined with 3D display enhance surgeon performance and task quality, especially in complex procedures like anastomosis.
• The benefits of AI-3D visualization are most pronounced in less experienced surgeons, aiding their skill acquisition in laparoscopic urology.