COMPARISON OF DIRECT VISION AND ELECTRONIC 2-DIMENSIONAL AND 3-DIMENSIONAL DISPLAY SYSTEMS ON SURGICAL TASK EFFICIENCY IN ENDOSCOPIC SURGERY

Task efficiency and knot strength was evaluated under standardized con ditions using direct vision and electronic imaging with two-dimensiona l (2-D) and three-dimensional (3-D) systems. Three operators with diff erent endoscopic surgical experience tied a surgeon's knot with standa rd endoscopic instruments using the three different visual systems in random order. Each operator tied 20 knots with each visual system. Med ian task efficiency (defined as the time to complete the knot) was 35. 0 (interquartile range (i.q.r.) 30.3-43.8) s for direct vision and 53. 0 (i.q.r. 45.3-62.8) s and 53.5 (i.q.r. 45.0-64.8) s for 2-D and 3-D i maging respectively (P < 0.05). With respect to direct vision, this re presented an overall degradation of task efficiency with the use of el ectronic imaging of 52 per cent, with no detectable difference between 2-D and 3-D imaging. The knot strength, representing the degree of ti ghtening, was weaker with electronic imaging but the difference was no t significant due largely to variation between the three operators.