El Boghdady Michael, Ramakrishnan Gobinath, Tang Benjie, Alijani Afshin
Cuschieri Skills Centre, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD19SY, UK.
World J Surg. 2018 Mar;42(3):688-694. doi: 10.1007/s00268-017-4220-3.
There is a strong evidence to suggest that 3D imaging improves the laparoscopic task performance when compared against 2D. However, to date, no study has explained why that might be. We identified six generic visual components during laparoscopic imaging and aimed to study each component in both 2D and 3D environments for comparison.
Twenty-four consented laparoscopic novices performed specific isolated tasks in a laparoscopic Endo Trainer in 2D and 3D separately. The six endpoints were the accuracy in detecting changes in the laparoscopic images in the following components: distance, area, angle, curvature, volume and spatial coordinates. All the components except the spatial coordinates were assessed by creation, measurement and comparison. Each component was analysed between 2D and 3D groups and within each group at different values. Tests of spatial coordinates were video-recorded and analysed for error number and error types by human reliability analysis technique. Errors types included past-pointing, not reaching the object and touching the wrong object. The results were statistically analysed with independent T test.
There was no statistically significant difference between 2D and 3D accuracy in the angle, area, distance and curvature. 3D performed more accurately in comparing volumes (p = 0.05). In spatial coordinates, there were a statistically significant higher number of errors in 2D as compared to 3D (p < 0.001). Past-pointing and touching the wrong objects were significantly higher in 2D (p < 0.05).
Between all the visual components, detecting change in volume and the spatial coordinates showed significant improvement in 3D environment when compared to 2D.
有强有力的证据表明，与二维成像相比，三维成像可提高腹腔镜手术的操作表现。然而，迄今为止，尚无研究解释其原因。我们在腹腔镜成像过程中识别出六个通用视觉组件，旨在研究二维和三维环境下每个组件并进行比较。
24名同意参与的腹腔镜新手分别在二维和三维腹腔镜模拟训练器上执行特定的孤立任务。六个终点指标是在以下组件中检测腹腔镜图像变化的准确性：距离、面积、角度、曲率、体积和空间坐标。除空间坐标外，所有组件均通过创建、测量和比较进行评估。对二维和三维组之间以及每组内不同值的每个组件进行分析。空间坐标测试进行视频记录，并通过人因可靠性分析技术分析错误数量和错误类型。错误类型包括过点、未到达目标和触碰错误目标。结果采用独立样本t检验进行统计学分析。
在角度、面积、距离和曲率方面，二维和三维准确性之间无统计学显著差异。在比较体积时，三维表现更准确（p = 0.05）。在空间坐标方面，二维的错误数量在统计学上显著高于三维（p < 0.001）。二维中的过点和触碰错误目标显著更高（p < 0.05）。
在所有视觉组件中，与二维相比，三维环境下检测体积和空间坐标的变化有显著改善。
