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.
Langenbecks Arch Surg. 2022 Nov;407(7):3069-3078. doi: 10.1007/s00423-022-02608-3. Epub 2022 Jul 22.
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.
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.
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.
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.
This trial was registered at clinicaltrials.gov (trial number: NCT03445429, registered February 26, 2018).
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。
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。
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。
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。
该试验在 clinicaltrials.gov 注册（试验编号：NCT03445429，注册日期：2018 年 2 月 26 日）。
