Department of General, Visceral, Cancer and Transplant Surgery, University Hospital of Cologne, University of Cologne, Cologne, Germany.
Department of Ophthalmology, University Hospital of Cologne, University of Cologne, Cologne, Germany.
Ann Surg. 2020 Nov;272(5):709-714. doi: 10.1097/SLA.0000000000004328.
To evaluate if "state-of-the-art" 3D- versus 4K-display techniques could influence surgical performance.
High quality minimally invasive surgery is challenging. Therefore excellent vision is crucial. 3D display technique (3D) and 2D-4K technique (4K) are designed to facilitate surgical performance, either due to spatial resolution (3D) or due to very high resolution (4K).
In randomized cross-over trial the surgical performance of medical students (MS), non-board certified surgeons (NBC), and board certified surgeons (BC) was compared using 3D versus 4K display technique at a minimally invasive training Parkour.
One hundred twenty-eight participants were included (February 2018 through October 2019, 49 MS, 39 NBC, 40 BC). The overall Parkour time (s) 3D versus 4K was 712.5 s ± 17.5 s versus 999.5 s ± 25.1 s (P < 0.001) for all levels of experience. It was (3D vs 4K) for MS (30 tasks) 555.4 s ± 28.9 s versus 858.7 s ± 41.6 s, (P < 0.0001), for NBC (42 tasks) 935.9 s ± 31.5 s versus 1274.1 s ± 45.1 s (P =< 0.001) and for BC (42 task) 646.3 s ± 30.9 s versus 865.7 s ± 43.7 s (P < 0.001). The overall number of mistakes was (3D vs 4K) 10.0 ± 0.5 versus 13.3 ± 0.7 (P < 0.001), for MS 8.9 ± 0.9 versus 13.1 ± 1.1 (P < 0.001), for NBC 12.45 ± 1.0 versus 16.7 ± 1.2 (P < 0.001) and for BC 8.8 ± 1.0 versus 10.0 ± 1.2 (P = 0.18). MS, BC, and NBC showed shorter performance time in 100% of the task with 3D (significantly in 6/7 tasks). For number of mistakes the effect was less pronounced for more experienced surgeons. The National Aeronautics and Space Administration-task load index was lower with 3D.
3D laparoscopic display technique optimizes surgical performance compared to the 4K technique. Surgeons benefit from the improved visualization regardless of their individual surgical expertise.
评估“最先进”的 3D-与 4K 显示技术是否会影响手术表现。
高质量的微创手术具有挑战性。因此，出色的视觉效果至关重要。3D 显示技术（3D）和 2D-4K 技术（4K）旨在通过空间分辨率（3D）或极高分辨率（4K）来促进手术表现。
在一项微创训练 Parkour 中，我们采用 3D 与 4K 显示技术，对医学生（MS）、非认证外科医生（NBC）和认证外科医生（BC）的手术表现进行了随机交叉试验比较。
共纳入 128 名参与者（2018 年 2 月至 2019 年 10 月，MS 49 名，NBC 39 名，BC 40 名）。所有经验水平的 Parkour 时间（s），3D 与 4K 分别为 712.5 s ± 17.5 s 与 999.5 s ± 25.1 s（P < 0.001）。MS（30 项任务）的时间分别为 555.4 s ± 28.9 s 与 858.7 s ± 41.6 s（P < 0.0001），NBC（42 项任务）的时间分别为 935.9 s ± 31.5 s 与 1274.1 s ± 45.1 s（P < 0.001），BC（42 项任务）的时间分别为 646.3 s ± 30.9 s 与 865.7 s ± 43.7 s（P < 0.001）。总体错误数（3D 与 4K）分别为 10.0 ± 0.5 与 13.3 ± 0.7（P < 0.001），MS 分别为 8.9 ± 0.9 与 13.1 ± 1.1（P < 0.001），NBC 分别为 12.45 ± 1.0 与 16.7 ± 1.2（P < 0.001），BC 分别为 8.8 ± 1.0 与 10.0 ± 1.2（P = 0.18）。MS、BC 和 NBC 在 100%的任务中表现时间更短（6/7 项任务中有显著改善）。对于错误数量，经验更丰富的外科医生的效果不那么明显。3D 的美国国家航空航天局任务负荷指数较低。
与 4K 技术相比，3D 腹腔镜显示技术优化了手术表现。无论手术经验如何，外科医生都能从改善的可视化中受益。
