Sun C C, Chiu A W, Chen K K, Chang L S
Division of Urology, Department of Surgery, Veterans General Hospital Taipei, Republic of China.
Urol Int. 2000;64(3):154-8. doi: 10.1159/000030517.
To compare the performance of laparoscopic skill assisted by a traditional two-dimensional (2D) and a three-dimensional (3D) endoscopic video system in a pelvic trainer.
The 3D imaging system (DeepVision((R)), Automated Medical Products Corp.) consists of a traditional single lens optic laparoscope, a light source, an endoscopic camera (Stryker), a DeepVision processor and a DeepVision monitor. The 2D images could be obtained with the same system without turning on the DeepVision processor. Thirty-four medical personnel with no laparoscopic surgical experience were enrolled to perform two skill tests, the object-pick-up and spatial orientation test in a trainer box. They were randomly divided into two groups, one group performed the test under 2D conditions first and 3D later, and another group performed the test under 3D conditions first and 2D later. The duration needed to complete the skill tests was recorded and the differences on performance time under 2D and 3D conditions were calculated for each participant. Two-way ANOVA was used to analyze the statistic difference on the performance time in two conditions.
The duration needed to complete the initial skill tests was similar among 2D and 3D conditions. For both tests, the average performance time decreased significantly for the second attempt regardless of 2D or 3D conditions. Statistic analysis disclosed significant difference for learning factor (p < 0.001 for object-pick-up test and p < 0.01 for spatial orientation test), but no significant difference between 2D and 3D conditions (p = 0.276 for object-pick-up test and p = 0.327 for spatial orientation test).
A significant decrease of the performance time at the second attempt reflected the importance of a learning process in laparoscopic surgery. It appears that no significant benefits were obtained by this 3D operating system for surgeons without laparoscopic surgical experience.
比较传统二维（2D）和三维（3D）内镜视频系统辅助下在盆腔训练器中腹腔镜操作技能的表现。
3D成像系统（DeepVision((R))，Automated Medical Products Corp.）由传统的单镜头光学腹腔镜、光源、内镜摄像头（史赛克）、DeepVision处理器和DeepVision监视器组成。不开启DeepVision处理器时，使用同一系统可获取2D图像。招募34名无腹腔镜手术经验的医务人员，在训练箱中进行两项技能测试，即物体抓取和空间定向测试。他们被随机分为两组，一组先在2D条件下进行测试，后在3D条件下进行测试，另一组先在3D条件下进行测试，后在2D条件下进行测试。记录完成技能测试所需的时间，并计算每位参与者在2D和3D条件下操作时间的差异。采用双向方差分析来分析两种条件下操作时间的统计学差异。
在2D和3D条件下，完成初始技能测试所需的时间相似。对于两项测试，无论2D还是3D条件，第二次尝试时的平均操作时间均显著缩短。统计学分析显示学习因素存在显著差异（物体抓取测试p < 0.001，空间定向测试p < 0.01），但2D和3D条件之间无显著差异（物体抓取测试p = 0.276，空间定向测试p = 0.327）。
第二次尝试时操作时间显著缩短反映了腹腔镜手术中学习过程的重要性。对于没有腹腔镜手术经验的外科医生来说，这种3D操作系统似乎没有带来显著益处。
