Is it worth revisiting laparoscopic three-dimensional visualization? A validated assessment

Abstract

Objectives: Pure laparoscopic urologic surgery is becoming the standard of care for many urologic procedures. Training surgeons without any experience in the field is still a challenge. It is well recognized that two-dimensional optics causes difficulty for the novice. Thus, we assessed a new-generation, three-dimensional (3D) visualization system.

Methods: Fifteen laparoscopically novice surgeons were asked to perform five validated laparoscopic training exercises using the two-dimensional and 3D systems in random order: (a) linear cutting and suturing; (b) curved cutting and suturing; (c) tubular suturing; (d) dorsal vein complex suturing simulation; and (e) urethrovesical anastomosis. The objective (time taken to complete the task versus the time needed by an expert) and subjective (accuracy on completion versus an expert's) scoring were performed independently by advanced laparoscopists. Statistical analysis was performed using the t test.

Results: All tasks were completed by the participants. The statistical analysis revealed a trend toward improved task performance using 3D visualization.

Conclusions: Our preliminary testing has suggested that the new-generation, 3D system used will be helpful for developing skills in laparoscopy for the novice surgeon.