Han Young Gi, Song Taejong, Kang Hyuna, Kang Du-Young, Oh Tae Yun
Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (South).
Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (South).
Wideochir Inne Tech Maloinwazyjne. 2020 Jun;15(2):283-289. doi: 10.5114/wiitm.2020.94347. Epub 2020 Apr 20.
The aim of the study was to evaluate the incidence and severity of visually induced motion sickness (VIMS) during 3D laparoscopy, in operators without prior experience.
Design: A retrospective comparative study (Canadian Task Force classification II-2). Setting: A university hospital. Intervention: Gynecologic surgery. Main outcome measure: This is a prospective observational study, which enrolled 9 surgeons as participants. None of these surgeons had any prior experience with 3D laparoscopy. Each participant performed 10 consecutive cases of 3D laparoscopy in patients with benign or premalignant gynecological diseases. The primary outcome measure was the incidence and severity of VIMS, which was evaluated using the validated Simulator Sickness Questionnaire. Personal preferences, discomfort, and ease of 3D laparoscopy were also evaluated.
Sixty-seven percent of surgeons experienced VIMS during their first 3D laparoscopy case. The incidence and severity of VIMS dramatically decreased from the second case onward. However, in some surgeons (22-44%), VIMS did not completely disappear until the tenth case. With respect to the discomfort using 3D laparoscopy, 84 self-reported responses after each surgery were "favor 3D laparoscopy," and "no" in 61 (72.6%) and 47 (55.9%) participants, respectively. Most participants found it easier to perform 3D laparoscopy than 2D laparoscopy.
The occurrence of visually induced symptoms in susceptible individuals during 3D laparoscopy is high, particularly during their first case. This suggests the need for increasing surgeons' awareness regarding the possibility of discomfort.
本研究旨在评估在无先前经验的操作者进行3D腹腔镜手术期间视觉诱发晕动病（VIMS）的发生率和严重程度。
设计：一项回顾性比较研究（加拿大工作组分类II - 2）。地点：一所大学医院。干预措施：妇科手术。主要观察指标：这是一项前瞻性观察性研究，招募了9名外科医生作为参与者。这些外科医生均无3D腹腔镜手术的先前经验。每位参与者连续为患有良性或癌前妇科疾病的患者进行10例3D腹腔镜手术。主要观察指标是VIMS的发生率和严重程度，使用经过验证的模拟器晕动病问卷进行评估。还评估了个人偏好、不适感以及3D腹腔镜手术的难易程度。
67%的外科医生在其首例3D腹腔镜手术病例中经历了VIMS。从第二例开始，VIMS的发生率和严重程度显著下降。然而，在一些外科医生中（22 - 44%），VIMS直到第十例才完全消失。关于使用3D腹腔镜手术的不适感，每次手术后84份自我报告的回复中，“支持3D腹腔镜手术”，在61名（72.6%）和47名（55.9%）参与者中分别为“否”。大多数参与者发现进行3D腹腔镜手术比2D腹腔镜手术更容易。
在3D腹腔镜手术期间，易感个体出现视觉诱发症状的情况很常见，尤其是在首例手术时。这表明需要提高外科医生对不适可能性的认识。
