Assessment of a three-dimensional operating system with skill tests in a pelvic trainer

Objectives: To compare the performance of laparoscopic skill assisted by a traditional two-dimensional (2D) and a three-dimensional (3D) endoscopic vi deo system in a pelvic trainer. Materials and Methods: The 3D imaging syste m (DeepVision(R), Automated Medical Products Corp.) consists of a tradition al single lens optic laparoscope, a light source, an endoscopic camera (Str yker), a DeepVision processor and a DeepVision monitor. The 2D images could be obtained with the same system without turning on the DeepVision process or. Thirty-four medical personnel with no laparoscopic surgical experience were enrolled to perform two skill tests, the object-pick-up and spatial or ientation test in a trainer box. They were randomly divided into two groups , one group performed the test under 2D conditions first and 3D later, and another group performed the test under 3D conditions first and 2D later. Th e duration needed to complete the skill tests was recorded and the differen ces on performance time under 2D and 3D conditions were calculated for each participant. Two-way AN OVA was used to analyze the statistic difference o n the performance time in two conditions. Results: The duration needed to c omplete the initial skill tests was similar among 2D and 3D conditions. For both tests, the average performance time decreased significantly for the s econd attempt regardless of 2D or 3D conditions. Statistic analysis disclos ed significant difference for learning factor (p < 0.001 for object-pick-up test and p < 0.01 for spatial orientation test), but no significant differ ence betwen 2D and 3D conditions (p = 0.276 for object-pick-up test and p = 0.327 for spatial orientation test). Conclusion: A significant decrease of the performance time at the second attempt reflected the importance of a l earning process in laparoscopic surgery. It appears that no significant ben efits were obtained by this 3D operating system for surgeons without laparo scopic surgical experience. Copyright (C) 2000 S. Karger AG. Basel.