Distraction and proficiency in laparoscopy: 2D versus robotic console 3D immersion

Area of Science:

• Surgical Technology
• Minimally Invasive Surgery
• Human Factors in Medicine

Background:

• Robotic-assisted laparoscopy (RL) offers mechanical advantages over conventional laparoscopy (CL).
• The impact of visual immersion and distraction on laparoscopic skill performance remains under-assessed.
• 3D optics in RL may enhance performance by increasing focus and depth perception.

Purpose of the Study:

• To compare laparoscopic skill performance between RL and CL.
• To evaluate the effect of distraction on performance in both RL and CL settings.
• To determine if the 3D optics of RL contribute to improved performance independently of robotic assistance.

Main Methods:

• Thirty-two novice participants were randomized into four groups: RL, RL with distraction (RL+D), CL, and CL with distraction (CL+D).
• Participants performed three Fundamentals of Laparoscopy Surgery tasks (peg transfer, circle cutting, suturing) three times each.
• Task completion time and errors were recorded and statistically analyzed for each group.

Main Results:

• Conventional laparoscopy with distraction (CL+D) showed significantly longer task completion times compared to other groups.
• Robotic-assisted laparoscopy (RL) and RL+D groups exhibited significantly shorter deviations in circle cutting (Task 2) and suturing (Task 3) compared to CL and CL+D.
• Distraction negatively impacted CL performance more than RL performance.

Conclusions:

• The immersive 3D optics of RL provide performance benefits, particularly under distracting conditions.
• Conventional 2D monitors offer limited ability to mitigate distraction during laparoscopic procedures.
• Enhanced depth perception and focus from 3D visualization may improve surgical outcomes in the operating room.