立体视觉对微创手术中手术操作的影响——IDOSP 研究（3D 与 4K 显示系统对微创手术中手术操作的影响）的一个子研究。
The influence of stereoscopic vision on surgical performance in minimal invasive surgery-a substudy of the IDOSP-Study (Influence of 3D- vs. 4 K-Display Systems on Surgical Performance in minimal invasive surgery).
机构信息
Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Joseph-Stelzmann-Straße 9, 50931, Cologne, Germany.
Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
出版信息
Langenbecks Arch Surg. 2022 Nov;407(7):3069-3078. doi: 10.1007/s00423-022-02608-3. Epub 2022 Jul 22.
PURPOSE
This study is a secondary analysis of the IDOSP trial published in the Annals of Surgery 2020. The aim of this study was to examine the influence of stereo acuity on surgical performance in a laparoscopic training parkour with 3D- versus 4 K-2D-display technique.
METHODS
The surgical performance of medical students (MS), non-board-certified surgeons (NBC), and board-certified surgeons (BC) was compared using 3D- versus 4 K-2D-display technique at a training parkour in a randomized cross-over trial. Stereo acuity was tested by TNO and Titmus Stereo tests.
RESULTS
Eighty-nine participants were included in this sub-trial. The median stereo acuity for all participants, measured with the Titmus test, was 25 s arc, with TNO test 30 s arc. Higher quality stereo vision, measured with the Titmus test, correlated significantly with a reduced parkour time (r = 0.26, p = 0.02) and error (r = 0.21, p = 0.048) with the 3D screen. The TNO test did not correlate significantly with parkour performance. There was no statistically significant correlation between parkour time nor error and stereo acuity using the 4 K system (p > 0.457 respectively). Higher age showed a significant correlation with lower stereo acuity measured with TNO (r = 0.21, p = 0.014), but not with the Titmus test (r = - 0.7, p = 0.39). Seven percent of the group "NBC and BC" showed reduced stereo acuity > 120 s arc with the Titmus test and 3% with the TNO test.
CONCLUSION
High-quality stereo vision is of utmost importance for surgical skills using a 3D-display system. This was most obvious for MS and for tasks that place particularly high demands on hand-eye coordination. The Titmus test was more precise than the TNO test to predict the benefit of a 3D monitor system. Experience and fine motor skills could partly compensate for a poorer stereo acuity.
TRIAL REGISTRATION
This trial was registered at clinicaltrials.gov (trial number: NCT03445429, registered February 26, 2018).
目的
本研究是对 2020 年《外科学年鉴》发表的 IDOSP 试验的二次分析。本研究旨在通过 3D 与 4K-2D 显示技术在腹腔镜训练公园中的比较，研究立体锐度对手术表现的影响。
方法
在一项随机交叉试验中，使用 3D 与 4K-2D 显示技术，对医学生（MS）、非委员会认证外科医生（NBC）和委员会认证外科医生（BC）的手术表现进行了比较。通过 TNO 和 Titmus 立体视测试来测试立体锐度。
结果
本亚试验共纳入 89 名参与者。所有参与者的 Titmus 测试中位立体锐度为 25 秒弧，TNO 测试为 30 秒弧。使用 Titmus 测试测量到的高质量立体视觉与 3D 屏幕的公园表现时间（r=0.26，p=0.02）和误差（r=0.21，p=0.048）呈显著相关。TNO 测试与公园表现无显著相关性。使用 4K 系统时，公园表现时间和误差与立体锐度均无显著相关性（p>0.457）。年龄较高与 TNO 测试测量的较低立体锐度呈显著相关性（r=0.21，p=0.014），但与 Titmus 测试无相关性（r=−0.7，p=0.39）。“NBC 和 BC”组中，有 7%的人使用 Titmus 测试的立体锐度>120 秒弧，3%的人使用 TNO 测试的立体锐度>120 秒弧。
结论
高质量的立体视觉对于使用 3D 显示系统的手术技能至关重要。这在 MS 以及对手眼协调要求特别高的任务中最为明显。Titmus 测试比 TNO 测试更精确地预测 3D 监测系统的益处。经验和精细运动技能可以部分弥补较差的立体锐度。
试验注册
该试验在 clinicaltrials.gov 注册（试验编号：NCT03445429，注册日期：2018 年 2 月 26 日）。
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