Department of General Surgery, Azienda Euganea ULSS 6, Via Casa di Ricovero, 40; 35013, Cittadella, Padua, Italy.
Department of General Surgery, Azienda Euganea ULSS 6, Schiavonia, Italy.
Int J Colorectal Dis. 2023 Jul 10;38(1):190. doi: 10.1007/s00384-023-04491-w.
Technological development has offered laparoscopic colorectal surgeons new video systems to improve depth perception and perform difficult task in limited space. The aim of this study was to assess the cognitive burden and motion sickness for surgeons during 3D, 2D-4 K or 3D-4 K laparoscopic colorectal procedures and to report post-operative data with the different video systems employed.
Patients were assigned to either 3D, 2D-4 K or 3D-4 K video and two questionnaires (Simulator Sickness Questionnaire-SSQ- and NASA Task Load Index -TLX) were used during elective laparoscopic colorectal resections (October 2020-August 2022) from two operating surgeons. Short-term results of the operations performed with the three different video systems were also analyzed.
A total of 113 consecutive patients were included: 41 (36%) in the 3D Group (A), 46 (41%) in the 3D-4 K Group and 26 (23%) in the 2D-4 K Group (C). Weighted and adjusted regression models showed no significant difference in cognitive load amongst the surgeons in the three groups of video systems when using the NASA-TLX. An increased risk for slight/moderate general discomfort and eyestrain in the 3D-4 K group compared with 2D-4 K group (OR = 3.5; p = 0.0057 and OR = 2.8; p = 0.0096, respectively) was observed. Further, slight/moderate difficulty focusing was lower in both 3D and 3D-4 K groups compared with 2D-4 K group (OR = 0.4; p = 0.0124 and OR = 0.5; p = 0.0341, respectively), and higher in the 3D-4 K group compared with 3D group (OR = 2.6; p = 0.0124). Patient population characteristics, operative time, post-operative staging, complication rate and length of stay were similar in the three groups of patients.
3D and 3D-4 K systems, when compared with 2D-4 K video technology, have a higher risk for slight/moderate general discomfort and eyestrain, but show lower difficulty focusing. Short post-operative outcomes do not differ, whichever imaging system is used.
技术发展为腹腔镜结直肠外科医生提供了新的视频系统，以提高深度感知能力并在有限的空间内完成困难的任务。本研究旨在评估 3D、2D-4K 或 3D-4K 腹腔镜结直肠手术期间外科医生的认知负担和运动病，并报告使用不同视频系统的术后数据。
患者被分配到 3D、2D-4K 或 3D-4K 视频组，两位手术医生在 2020 年 10 月至 2022 年 8 月期间进行择期腹腔镜结直肠切除术时使用了两个问卷（模拟器晕动病问卷-SSQ-和 NASA 任务负荷指数-TLX）。还分析了使用三种不同视频系统进行的手术的短期结果。
共纳入 113 例连续患者：3D 组（A 组）41 例（36%），3D-4K 组 46 例（41%），2D-4K 组 26 例（23%）。当使用 NASA-TLX 时，加权和调整后的回归模型显示，三组视频系统的外科医生认知负荷无显著差异。与 2D-4K 组相比，3D-4K 组出现轻微/中度一般不适和眼疲劳的风险增加（OR=3.5；p=0.0057 和 OR=2.8；p=0.0096）。此外，与 2D-4K 组相比，3D 和 3D-4K 组的轻微/中度聚焦困难程度较低（OR=0.4；p=0.0124 和 OR=0.5；p=0.0341），而 3D-4K 组则高于 3D 组（OR=2.6；p=0.0124）。三组患者的人群特征、手术时间、术后分期、并发症发生率和住院时间相似。
与 2D-4K 视频技术相比，3D 和 3D-4K 系统出现轻微/中度一般不适和眼疲劳的风险更高，但聚焦困难程度较低。使用任何成像系统，术后短期结果均无差异。
