A study of the visual symptoms in two-dimensional versus three-dimensional laparoscopy

Area of Science:

• Minimally Invasive Surgery
• Ophthalmology
• Human Factors Engineering

Background:

• Laparoscopic surgery increasingly utilizes 3D imaging, raising concerns about surgeon visual comfort.
• Previous reports indicate visual strain and related symptoms during 3D laparoscopy.
• Understanding visual differences between 2D and 3D laparoscopic environments is crucial for optimizing surgical performance and well-being.

Purpose of the Study:

• To compare the incidence and severity of visual symptoms in 3D versus 2D laparoscopic imaging.
• To investigate the efficacy of simple eye exercises in mitigating visual discomfort during 3D laparoscopy.

Main Methods:

• 24 novice laparoscopic surgeons performed standardized tasks in both 2D and 3D environments.
• Visual symptoms were assessed using a validated questionnaire before and after tasks.
• Participants undergoing 3D tasks were randomized to receive or not receive 2 minutes of eye exercises.

Main Results:

• Significant visual symptoms and eye strain were reported in the 2D setting (p<0.01).
• Difficulty in refocusing between distances was significantly higher in the 3D setting (p<0.05).
• Eye exercises showed no significant improvement in visual symptoms for the 3D group.

Conclusions:

• Both 2D and 3D laparoscopy can induce visual symptoms.
• Eye strain is more prominent in 2D, while refocusing difficulties are more common in 3D.
• Current eye exercise protocols do not effectively alleviate 3D laparoscopy-related visual symptoms.