NEW ORLEANS, LA USA (UroToday.com) - Recent technological advancements have led to the introduction of new 3-dimensional (3D) cameras in laparoscopic surgery. The 3D view has been touted as useful during robotic surgery, however, there has been limited investigation into the utility of 3D imaging in laparoscopy.
The study group University of California Irvine performed a prospective, randomized crossover trial comparing a 0° 3D camera with a conventional 0º 2-dimensional (2D) camera using a high definition monitor (Karl Storz, Tuttlingen, Germany). All participants completed 6 standardized basic skills tasks. Quality testing scores were measured by number of drops, grasping attempts, and precision of needle entry and exiting. Additionally, resolution, color distribution, depth of field, and distortion were measured using optical test targets.
Twenty-four participants were evaluated in this study including 10 medical students, 7 residents, and 7 expert surgeons. The data showed a significant difference in the performance in all 6 skill tasks for the 3 levels of surgical expertise and training levels in 2D versus 3D except for the cut the line quality score and the peg transfer quality score. Adjusting for training level, 3D camera image results were superior for most metrics, including the number of rings left, ring transfer quality score, thread the rings (# of rings), and thread the rings quality score. Camera image was also superior for knot tying (quality score), peg transfer (time in sec), peg transfer/pegs left, and for peg transfer quality score. The 3D camera system showed significantly less distortion and a higher depth of field compared to the 2D camera system.
Overall, the authors concluded that in this in vitro evaluation, the 3D laparoscopic imaging resulted in a significantly better skill task-performance in depth perception, spatial location, and precision compared to the conventional 2D laparoscopic imaging. In the laboratory environment, the 3D imaging system resulted in a reduction of correctional moves and a higher degree of accuracy during grasping and suturing skill task. With this improved quality of vision, even expert laparoscopic surgeons may benefit from 3D imaging.
A lively discussion followed the presentation of this data. While the system remains investigational in the United States, it has been in use in Europe. European urologists cited their clinical experience, noting that they agree with the presented data. They suggested that the 3D system improves both complex tasks such as laparoscopic suturing as well as routine dissection. They noted that even experienced laparoscopists enjoy the benefits of the 3D laparoscopic technology.
Presented by Achim Lusch, MD
Click HERE to read the abstract and view the poster
Reported by:
Achim Lusch, MD and Jaime Landman, MD from the 31st World Congress of Endourology (WCE) - October 22 - 26, 2013 - New Orleans, LA USA
Department of Urology, University of California, Irvine, USA
