Zwimpfer Tibor Andrea, Lacher Dominik, Fellmann-Fischer Bernhard, Mueller Michael
University Hospital Basel, Gynecological Clinic, Basel, Switzerland.
Hospital Limmattal, Zürich, Switzerland.
BMC Surg. 2020 Nov 9;20(1):276. doi: 10.1186/s12893-020-00892-8.
Vision is an essential element of laparoscopic surgery that defines the outcome of an operation in regards to time, mistakes and precision. A 3-dimensional (3D) perspective may improve vision during an operation. Therefore, this study was designed to compare 3D versus 2-dimensional (2D) perspectives using a pelvitrainer model.
Fifty candidates were divided into 3 categories based on different experience levels. The candidates were randomised into two groups, with each group performing the same 4 standardised tasks. Group A approached the tasks first with 3D high definition and in a second turn with 2D high definition. Group B carried out the tasks with the systems in reverse order. Task completion time and the number of mistakes made for each task were recorded. After completing the tasks, participants answered questions concerning the two systems.
Group A was, on average, 20% faster at all four tasks and made approximately 18% fewer mistakes in two of the tasks in comparison to group B. The experts significantly benefited from the 3D system in terms of accuracy compared to non-experts and students. The students demonstrated a significantly greater benefit from the 3D system when performing non-linear, continuous movements. Loss of concentration occurred at the same rate for subjects using the 2D and 3D systems. Nausea and dizziness were reported only when working with the 3D system. 91% found the 3D system advantageous for accomplishing the tasks.
Irrespective of experience level, 3D laparoscopy shows advantages in saving time, increasing accuracy and reducing mistakes. These benefits were also accompanied by subjective advantages that were noted by the participants. However, the more complex the task, the less significant the benefit of the 3D system and some people feel handicapped by the eyewear.
视觉是腹腔镜手术的关键要素，关乎手术在时间、失误及精准度方面的结果。三维（3D）视角可能会改善手术中的视觉效果。因此，本研究旨在使用盆腔训练模型比较3D与二维（2D）视角。
50名参与者根据不同经验水平分为3类。参与者被随机分为两组，每组执行相同的4项标准化任务。A组先以3D高清视角执行任务，然后再以2D高清视角执行。B组则以相反顺序使用系统执行任务。记录每项任务的完成时间和所犯错误的数量。完成任务后，参与者回答有关这两种系统的问题。
与B组相比，A组在所有四项任务上平均快20%，且在两项任务中所犯错误约少18%。与非专家和学生相比，专家在准确性方面从3D系统中显著受益。学生在进行非线性连续动作时从3D系统中获得的益处显著更大。使用2D和3D系统的受试者注意力不集中的发生率相同。仅在使用3D系统时报告有恶心和头晕现象。91%的人认为3D系统有利于完成任务。
无论经验水平如何，3D腹腔镜检查在节省时间、提高准确性和减少失误方面均显示出优势。这些益处还伴随着参与者所指出的主观优势。然而，任务越复杂，3D系统的益处就越不显著，而且有些人觉得佩戴眼镜不方便。
