Testing Distinct Three-Dimensional Effects in Laparoscopy: A Prospective Randomized Trial Using the Lübecker Toolbox...

Area of Science:

• Surgical Technology
• Medical Imaging
• Human Factors Engineering

Background:

• Stereoscopic laparoscopic systems offer a three-dimensional (3D) view in minimally invasive surgery (MIS), potentially enhancing hand-eye coordination.
• The effectiveness of 3D systems can vary based on the stereo base used in endoscope construction.
• Investigating the impact of different stereo bases on the 3D effect is crucial for optimizing surgical visualization.

Purpose of the Study:

• To evaluate the influence of different stereo bases (2.5 mm vs. 3.8 mm) on the 3D effect in laparoscopic surgery.
• To compare the learning curves of MIS skills using two different 3D laparoscopic systems.
• To assess the transition from 3D to 2D visualization after skill acquisition.

Main Methods:

• A prospective randomized study involving 42 MIS-inexperienced participants.
• Evaluation of two laparoscopic 3D systems (2.5 mm and 3.8 mm stereo bases) using the Lübeck Toolbox (LTB) video box trainer.
• Assessment of skill acquisition based on time and repetitions; comparison with 2D visualization and a prior 2D system study.

Main Results:

• No significant difference in repetitions required between the 2.5 mm and 3.8 mm stereo base systems for most LTB exercises.
• Switching from 3D to 2D visualization significantly increased time for the suturing exercise (95.22s to 119.3s).
• Significant reduction in repetitions needed to achieve LTB exercise goals with 3D systems compared to historical 2D data.

Conclusions:

• Both 2.5 mm and 3.8 mm stereo bases are suitable for 3D laparoscopic system design.
• Basic MIS skills are learned more rapidly with 3D systems compared to 2D systems.
• Relearning compensatory mechanisms is necessary when the 3D effect is removed after initial 3D training.