Impact of three-dimensional imaging in acquisition of laparoscopic skills in novice operators

Abstract

BACKGROUND: Three-dimensional (3D) laparoscopes have been developed to maintain the perception of depth in the operating field. Two-dimensional (2D) imaging relies on tactile feedback, visual cues, and previous experience. The aim of this study was to test if 3D laparoscopic vision is superior to 2D laparoscopic vision in training novice operators in completing set laparoscopic tasks. MATERIALS AND METHODS: The study population consisted of 20 interns and medical students. The participants were randomized to completing tasks using a 2D or 3D system. These included pegboard transfer (PT), continuous suturing (CS), and intracorporeal knot-tying (IK). The time to complete the task and number of errors made were recorded. RESULTS: Following adjustment for potential confounders, time to complete CS and IK was significantly longer among participants who used the 2D laparoscope compared with those who used the 3D laparoscope (CS, P<.0001; IK, P<.0001). This same effect was not demonstrated in time to perform PT (PT, P=.04). The 2D laparoscope was associated with a significant increase in the number of errors on the IK task (P<.0001) but not on the PT or CS tasks (PT, P=.35; CS, P=.26). CONCLUSIONS: The 3D system assists novice operators perform more complex laparoscopic tasks in a decreased amount of time and with fewer errors.