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21 Effectiveness of 3D-imaging system on simple and suturing tasks for laparoscopic training
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Effectiveness of 3D-imaging system on simple and suturing tasks for laparoscopic training Eur Urol Suppl 2013;12;e21
Iwamura M.1, Ito A.2, Hoshi A.3, Miyajima A.4, Nakagawa K.4, Kinoshita H.5, Arai Y.2, Terachi T.3, Baba S.1, Matsuda T.5 1Kitasato
University School of Medicine, Dept. of Urology, Sagamihara, Japan, 2Tohoku University School of Medicine, Dept. of
Urology, Sendai, Japan, 3Tokai University School of Medicine, Dept. of Urology, Isehara, Japan, 4Keio University School of Medicine, Dept. of Urology, Tokyo, Japan, 5Kansai Medical University, Dept. of Urology and Andrology, Hirakata, Japan INTRODUCTION & OBJECTIVES: Three-dimensional (3D) imaging systems have been introduced in various medical applications. 3D images are expected for laparoscopic surgeons to perform more precise procedures by affecting on their spatial cognitive function. However, there is only limited data evaluating the effectiveness of 3D imaging systems, probably due to a difficulty of eliminating factors from patients and surgeons’ skill. We conducted randomized controlled trials to evaluate whether 3D images are useful in performing dry box tasks compared to two dimensional (2D) imaging systems. MATERIAL & METHODS: A total of 53 urologists from 5 different institutes joined in this study. The subjects were classified into 4 groups according to their laparoscopic experience, and were further randomized into 2D foregoing and 3D foregoing subjects. A simple task model was designed to evaluate the influence of imaging on a simple work by measuring the labor time. The suturing task was conducted to evaluate the effectiveness of images on the labor time of 6-intermittent vesicourethral anastomosis. Each subject performed 5 consecutive procedures under 2D and 3D images, respectively. At least 72-hour interval was imposed before starting the latter 5 procedures under different imaging system. In this study, we used Olympus 3D laparothoraco videoscope systems provided to us by Olympus Medical Systems Corp. (Tokyo, Japan). RESULTS: In a simple task study, mean labor time of each group was equivalent, suggesting successfully avoiding the influence of subjects’ laparoscopic experience. In contrast, there was a significant reverse correlation between mean suturing time and laparoscopic experience. These findings were common in 2D and 3D images. Although the learning curve effect was observed in both tasks, the fractional shortening of labor time (decline of the learning curve) was similar between 2D and 3D imaging systems. Mean labor time under 3D imaging system was significantly shorter than that under 2D system in both simple task (42.5 vs. 49.1 sec., p<0.001) and suturing task (911 vs. 1004 sec., p = 0.0018). Interestingly, confining to 3D foregoing subjects, this difference was not statistically significant, suggesting that the experience of tasks under 3D imaging could minimize the elongation of the labor time under 2D imaging. CONCLUSIONS: In the present study, we demonstrate a subjective benefit of 3D imaging system in reducing the labor time of laparoscopic dry box tasks. Our results suggest that, irrespective of laparoscopic experience, 3D imaging system may shorten laparoscopic operative time, probably, by enhancement of surgeon’s spatial cognitive function.
Effectiveness of 3D-imaging system on simple and suturing tasks for laparoscopic training Eur Urol Suppl 2013;12;e21
Iwamura M.1, Ito A.2, Hoshi A.3, Miyajima A.4, Nakagawa K.4, Kinoshita H.5, Arai Y.2, Terachi T.3, Baba S.1, Matsuda T.5 1Kitasato
University School of Medicine, Dept. of Urology, Sagamihara, Japan, 2Tohoku University School of Medicine, Dept. of
Urology, Sendai, Japan, 3Tokai University School of Medicine, Dept. of Urology, Isehara, Japan, 4Keio University School of Medicine, Dept. of Urology, Tokyo, Japan, 5Kansai Medical University, Dept. of Urology and Andrology, Hirakata, Japan INTRODUCTION & OBJECTIVES: Three-dimensional (3D) imaging systems have been introduced in various medical applications. 3D images are expected for laparoscopic surgeons to perform more precise procedures by affecting on their spatial cognitive function. However, there is only limited data evaluating the effectiveness of 3D imaging systems, probably due to a difficulty of eliminating factors from patients and surgeons’ skill. We conducted randomized controlled trials to evaluate whether 3D images are useful in performing dry box tasks compared to two dimensional (2D) imaging systems. MATERIAL & METHODS: A total of 53 urologists from 5 different institutes joined in this study. The subjects were classified into 4 groups according to their laparoscopic experience, and were further randomized into 2D foregoing and 3D foregoing subjects. A simple task model was designed to evaluate the influence of imaging on a simple work by measuring the labor time. The suturing task was conducted to evaluate the effectiveness of images on the labor time of 6-intermittent vesicourethral anastomosis. Each subject performed 5 consecutive procedures under 2D and 3D images, respectively. At least 72-hour interval was imposed before starting the latter 5 procedures under different imaging system. In this study, we used Olympus 3D laparothoraco videoscope systems provided to us by Olympus Medical Systems Corp. (Tokyo, Japan). RESULTS: In a simple task study, mean labor time of each group was equivalent, suggesting successfully avoiding the influence of subjects’ laparoscopic experience. In contrast, there was a significant reverse correlation between mean suturing time and laparoscopic experience. These findings were common in 2D and 3D images. Although the learning curve effect was observed in both tasks, the fractional shortening of labor time (decline of the learning curve) was similar between 2D and 3D imaging systems. Mean labor time under 3D imaging system was significantly shorter than that under 2D system in both simple task (42.5 vs. 49.1 sec., p<0.001) and suturing task (911 vs. 1004 sec., p = 0.0018). Interestingly, confining to 3D foregoing subjects, this difference was not statistically significant, suggesting that the experience of tasks under 3D imaging could minimize the elongation of the labor time under 2D imaging. CONCLUSIONS: In the present study, we demonstrate a subjective benefit of 3D imaging system in reducing the labor time of laparoscopic dry box tasks. Our results suggest that, irrespective of laparoscopic experience, 3D imaging system may shorten laparoscopic operative time, probably, by enhancement of surgeon’s spatial cognitive function.