Tasman A J, Stammberger H
Department of Otorhinolaryngology, University of Heidelberg, Germany.
Am J Rhinol. 1998 Nov-Dec;12(6):389-92. doi: 10.2500/105065898780707946.
A matter of debate is whether the use of a video-endoscope impairs visual orientation and manual precision in endonasal surgery. We investigated the influence of video-endoscopy compared to endoscopy on stereoacuity in a model of the nasal cavity. Twenty medical staff members were asked to touch defined points in a spatial model of the nasal cavity as quickly as possible and in correct order using 0 degree and 30 degrees endoscopes, looking directly through the endoscope or looking at a video monitor connected to a CCD camera on the endoscope. Time, number of omissions of points and faults in point sequence were recorded. Manipulations were significantly quicker when the "operative field" was seen directly through the endoscope compared to orientation from the monitor for both 0 degree endoscope 96 +/- 4.7 s. vs. 108 +/- 5.6 s. and 30 degrees endoscope 84 +/- 3.9 s. vs. 96 +/- 5.5 s. (+/- SEM). There was no difference in number of omissions and faults in sequence between "endoscope" and "video-endoscope." The fact that the use of a video-endoscope did not increase the number of faults in our experiment does not support the notion that performing endoscopic sinus surgery using a monitor is unsafe. In the hands of the participants who were experienced with the endoscope, however, the use of a video-endoscope slowed down manipulations to a significant degree. To which extent this may be due to the effect of training or to superiority of the endoscope per se will remain a matter of discussion until a group of experienced video-endoscopists will have repeated the study.
一个存在争议的问题是，在鼻内手术中使用视频内窥镜是否会损害视觉定向和手部操作精度。我们在鼻腔模型中研究了视频内窥镜与传统内窥镜相比对立体视敏度的影响。20名医务人员被要求使用0度和30度内窥镜尽快且按正确顺序触摸鼻腔空间模型中的特定点，分别是直接通过内窥镜观察或看着连接在内窥镜上的CCD摄像机的视频监视器进行操作。记录操作时间、遗漏点的数量和点顺序错误情况。对于0度内窥镜，直接通过内窥镜观察“手术视野”时操作明显更快（96±4.7秒对108±5.6秒），对于30度内窥镜也是如此（84±3.9秒对96±5.5秒）（±标准误）。“内窥镜”和“视频内窥镜”在遗漏点数量和顺序错误方面没有差异。在我们的实验中，使用视频内窥镜并未增加错误数量，这一事实并不支持使用监视器进行内窥镜鼻窦手术不安全的观点。然而，在有内窥镜操作经验的参与者手中，使用视频内窥镜会使操作显著变慢。在一组有经验的视频内窥镜操作人员重复该研究之前，这在多大程度上可能是由于训练效果或内窥镜本身的优越性仍有待讨论。
