Life and Health Sciences Research Institute, Universidade do Minho, Braga, Portugal; Urology Unit, Magna Graecia University, Catanzaro, Italy.
Urology. 2013 Dec;82(6):1444-50. doi: 10.1016/j.urology.2013.07.047. Epub 2013 Oct 2.
To compare the last generation of 3-dimensional imaging (3D) vs standard 2-dimensional imaging (2D) laparoscopy.
A prospective observational study was conducted during the 4th Minimally Invasive Urological Surgical Week Course held in Braga (Portugal) in April 2013. The course participants and faculty were asked to perform standardized tasks in the dry laboratory setting and randomly assigned into 2 study groups; one starting with 3D, the other with 2D laparoscopy. The 5 tasks of the European Training in Basic Laparoscopic Urological Skills were performed. Time to complete each task and errors made were recorded and analyzed. An end-of-study questionnaire was filled by the participants.
Ten laparoscopic experts and 23 laparoscopy-naïve residents were included. Overall, a significantly better performance was obtained using 3D in terms of time (1115 seconds, interquartile range [IQR] 596-1469 vs 1299 seconds, IQR 620-1723; P = .027) and number of errors (2, IQR 1-3 vs 3, IQR 2-5.5; P = .001). However, the experts were faster only in the "peg transfer" task when using the 3D, whereas naïves improved their performance in 3 of the 5 tasks. A linear correlation between level of experience and performance was found. Three-dimensional imaging was perceived as "easier" by a third of the laparoscopy-naïve participants (P = .027).
Three-dimensional imaging seems to facilitate surgical performance of urologic surgeons without laparoscopic background in the dry laboratory setting. The advantage provided by 3D for those with previous laparoscopic experience remains to be demonstrated. Further studies are needed to determine the actual advantage of 3D over standard 2D laparoscopy in the clinical setting.
比较上一代三维成像（3D）与标准二维成像（2D）腹腔镜检查。
在 2013 年 4 月于葡萄牙布拉加举行的第四届微创泌尿外科手术周课程中进行了一项前瞻性观察研究。要求课程参与者和教师在干实验室环境中进行标准化任务，并随机分为 2 个研究组；一组从 3D 开始，另一组从 2D 腹腔镜开始。完成欧洲基本腹腔镜泌尿外科技能培训的 5 项任务。记录并分析完成每项任务的时间和错误。参与者填写了一份课程结束后问卷。
共纳入 10 名腹腔镜专家和 23 名腹腔镜初学者。总体而言，使用 3D 可显著提高时间（1115 秒，四分位距[IQR] 596-1469 与 1299 秒，IQR 620-1723；P =.027）和错误数量（2，IQR 1-3 与 3，IQR 2-5.5；P =.001）的性能。然而，专家仅在使用 3D 时的“钉转移”任务中更快，而初学者在 5 项任务中的 3 项任务中提高了表现。发现经验水平与绩效之间存在线性相关性。三分之一的腹腔镜初学者认为 3D 成像“更容易”（P =.027）。
在干实验室环境中，3D 成像似乎可以使没有腹腔镜背景的泌尿科医生更容易进行手术。对于有先前腹腔镜经验的人，3D 提供的优势仍有待证明。需要进一步的研究来确定 3D 在临床环境中相对于标准 2D 腹腔镜的实际优势。
