Gómez-Gómez E, Carrasco-Valiente J, Valero-Rosa J, Campos-Hernández J P, Anglada-Curado F J, Carazo-Carazo J L, Font-Ugalde P, Requena-Tapia M J
Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España.
Departamento de Urología, Hospital Universitario Reina Sofía, Córdoba, España.
Actas Urol Esp. 2015 May;39(4):229-35. doi: 10.1016/j.acuro.2014.09.008. Epub 2014 Nov 12.
To assess the effect of vision in three dimensions (3D) versus two dimensions (2D) on mental workload and laparoscopic performance during simulation-based training.
A prospective, randomized crossover study on inexperienced students in operative laparoscopy was conducted. Forty-six candidates executed five standardized exercises on a pelvitrainer with both vision systems (3D and 2D). Laparoscopy performance was assessed using the total time (in seconds) and the number of failed attempts. For workload assessment, the validated NASA-TLX questionnaire was administered.
3D vision improves the performance reducing the time (3D = 1006.08 ± 315.94 vs. 2D = 1309.17 ± 300.28; P < .001) and the total number of failed attempts (3D = .84 ± 1.26 vs. 2D = 1.86 ± 1.60; P < .001). For each exercise, 3D vision also shows better performance times: "transfer objects" (P = .001), "single knot" (P < .001), "clip and cut" (P < .05), and "needle guidance" (P < .001). Besides, according to the NASA-TLX results, less mental workload is experienced with the use of 3D (P < .001). However, 3D vision was associated with greater visual impairment (P < .01) and headaches (P < .05).
The incorporation of 3D systems in laparoscopic training programs would facilitate the acquisition of laparoscopic skills, because they reduce mental workload and improve the performance on inexperienced surgeons. However, some undesirable effects such as visual discomfort or headache are identified initially.
评估三维（3D）视觉与二维（2D）视觉对基于模拟训练的心理负荷及腹腔镜操作表现的影响。
对腹腔镜手术经验不足的学生进行一项前瞻性随机交叉研究。46名受试者使用两种视觉系统（3D和2D）在盆腔模型训练器上进行五项标准化练习。通过总时间（秒）和失败尝试次数评估腹腔镜操作表现。使用经过验证的NASA-TLX问卷进行心理负荷评估。
3D视觉可改善操作表现，减少时间（3D = 1006.08 ± 315.94 vs. 2D = 1309.17 ± 300.28；P < .001）以及失败尝试总数（3D = .84 ± 1.26 vs. 2D = 1.86 ± 1.60；P < .001）。对于每项练习，3D视觉也显示出更好的操作时间：“转移物体”（P = .001）、“单结打结”（P < .001）、“夹闭与切断”（P < .05）和“针引导”（P < .001）。此外，根据NASA-TLX结果，使用3D时心理负荷较低（P < .001）。然而，3D视觉与更严重的视觉障碍（P < .01）和头痛（P < .05）相关。
在腹腔镜训练项目中引入3D系统将有助于腹腔镜技能的掌握，因为它们可减轻心理负荷并提高经验不足的外科医生的操作表现。然而，最初会发现一些不良影响，如视觉不适或头痛。
