Department of Urology, University of California , Irvine, Orange, California.
J Endourol. 2014 Feb;28(2):261-6. doi: 10.1089/end.2013.0344. Epub 2014 Jan 10.
Recent technological advancements have led to the introduction of new three-dimensional (3D) cameras in laparoscopic surgery. The 3D view has been touted as useful during robotic surgery, however, there has been limited investigation into the utility of 3D in laparoscopy.
We performed a prospective, randomized crossover trial comparing a 0° 3D camera with a conventional 0° two-dimensional (2D) camera using a high definition monitor (Karl Storz, Tuttlingen, Germany). All participants completed six standardized basic skills tasks. Quality testing scores were measured by the number of drops, grasping attempts, and precision of needle entry and exiting. Additionally, resolution, color distribution, depth of field and distortion were measured using optical test targets.
In this pilot study, we evaluated 10 medical students, 7 residents, and 7 expert surgeons. There was a significant difference in the performance in all the six skill tasks, for the three levels of surgical expertise and training levels in 2D vs 3D except for the cut the line quality score and the peg transfer quality score. Adjusting for the training level, 3D camera image results were superior for the number of rings left (p=0.041), ring transfer quality score (p=0.046), thread the rings (no. of rings) (p=0.0004), and thread the rings quality score (p=0.0002). The 3D camera image was also superior for knot tying (quality score) (p=0.004), peg transfer (time in seconds) (p=0.047), peg transfer pegs left (p=0.012), and for peg transfer quality score (p=0.001). The 3D camera system showed significantly less distortion (p=0.0008), a higher depth of field (p=0.0004) compared with the 2D camera system.
3D laparoscopic camera equipment results in a significant improvement in depth perception, spatial location, and precision of surgical performance compared with the conventional 2D camera equipment. With this improved quality of vision, even expert laparoscopic surgeons may benefit from 3D imaging.
最近的技术进步使得腹腔镜手术中引入了新的三维（3D）摄像头。3D 视图在机器人手术中被认为是有用的，然而，对于腹腔镜手术中 3D 的实用性的研究有限。
我们进行了一项前瞻性、随机交叉试验，比较了使用高清监视器（德国卡尔史托斯，图特林根）的 0° 3D 摄像机与传统的 0°二维（2D）摄像机。所有参与者都完成了六项标准化的基本技能任务。通过掉落物数量、抓握尝试次数、针进出的精确性来衡量质量测试得分。此外，还使用光学测试目标测量分辨率、颜色分布、景深和失真。
在这项初步研究中，我们评估了 10 名医学生、7 名住院医师和 7 名专家外科医生。在 2D 与 3D 的所有六项技能任务中，在手术专业知识和培训水平的三个层次上，都存在显著差异，除了切割线质量评分和钉转移质量评分。在调整培训水平后，3D 摄像机图像结果在留下的戒指数量（p=0.041）、戒指转移质量评分（p=0.046）、穿线戒指（戒指数量）（p=0.0004）和穿线戒指质量评分（p=0.0002）方面表现更好。3D 摄像机图像在打结（质量评分）（p=0.004）、钉转移（用时，秒）（p=0.047）、钉转移留下的钉（p=0.012）和钉转移质量评分（p=0.001）方面也表现更好。3D 摄像机系统的失真度明显较低（p=0.0008），景深较高（p=0.0004），与 2D 摄像机系统相比。
与传统的 2D 摄像机设备相比，3D 腹腔镜摄像设备可显著提高深度感知、空间位置和手术操作的精度。有了这种视觉质量的提高，即使是经验丰富的腹腔镜外科医生也可能受益于 3D 成像。
