Nishi Masayasu, Kanaji Shingo, Otake Yoshito, Harada Hitoshi, Yamamoto Masashi, Oshikiri Taro, Nakamura Tetsu, Suzuki Satoshi, Suzuki Yuki, Hiasa Yuta, Sato Yoshinobu, Kakeji Yoshihiro
Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Surgery. 2017 May;161(5):1334-1340. doi: 10.1016/j.surg.2016.08.060. Epub 2016 Nov 30.
The recent development of stereoscopic images using 3-dimensional monitors is expected to improve techniques for laparoscopic operation. Several studies have reported technical advantages in using 3-dimensional monitors with regard to operative accuracy and working speed, but there are few reports that analyze forceps motions by 3-dimensional optical tracking systems during standardized laparoscopic phantom tasks. We attempted to develop a 3-dimensional motion analysis system for assessing laparoscopic tasks and to clarify the efficacy of using stereoscopic images from a 3-dimensional monitor to track forceps movement during laparoscopy.
Twenty surgeons performed 3 tasks (Task 1: a simple operation by the dominant hand, Task 2: a simple operation using both hands, Task 3: a complicated operation using both hands) under 2-dimensional and 3-dimensional systems. We tracked and recorded the motion of forceps tips with an optical marker captured by a 3-dimensional position tracker. We analyzed factors such as forceps path lengths, operation times, and technical errors for each task and compared the results of 2-dimensional and 3-dimensional monitors.
Mean operation times and technical errors were improved significantly for all tasks performed under the 3-dimensional system compared with the 2-dimensional system; in addition, mean path lengths for the forceps tips were shorter for all tasks performed under the 3-dimensional system.
We found that stereoscopic images using a 3-dimensional monitor improved operative techniques with regard to increased accuracy and shorter path lengths for forceps movement, which resulted in a shorter operation time for basic phantom laparoscopic tasks.
利用三维显示器的立体图像的最新发展有望改善腹腔镜手术技术。多项研究报告了使用三维显示器在手术准确性和工作速度方面的技术优势，但很少有报告分析在标准化腹腔镜模拟任务中三维光学跟踪系统对镊子动作的影响。我们试图开发一种用于评估腹腔镜任务的三维运动分析系统，并阐明使用三维显示器的立体图像来跟踪腹腔镜手术期间镊子运动的效果。
20名外科医生在二维和三维系统下执行3项任务（任务1：优势手进行的简单操作，任务2：双手进行的简单操作，任务3：双手进行的复杂操作）。我们用三维位置跟踪器捕获的光学标记跟踪并记录镊子尖端的运动。我们分析了每项任务的镊子路径长度、操作时间和技术误差等因素，并比较了二维和三维显示器的结果。
与二维系统相比，在三维系统下执行的所有任务的平均操作时间和技术误差均有显著改善；此外，在三维系统下执行的所有任务中，镊子尖端的平均路径长度更短。
我们发现，使用三维显示器的立体图像提高了手术技术，提高了准确性，缩短了镊子移动的路径长度，从而缩短了基本腹腔镜模拟任务的操作时间。
