Quantitative comparison of operative skill using 2- and 3-dimensional monitors during laparoscopic phantom tasks

Background. The recent development of stereoscopic images using 3-dimensional monitors is expected to improve techniques for laparoscopic operation. Several studies have reported technical advantages in using 3-dimensional monitors with regard to operative accuracy and working speed, but there are few reports that analyze forceps motions by 3-dimensional optical tracking systems during standardized laparoscopic phantom tasks. We attempted to develop a 3-dimensional motion analysis system for assessing laparoscopic tasks and to clarify the efficacy of using stereoscopic images from a 3-dimensional monitor to track forceps movement during laparoscopy. Methods. Twenty surgeons performed 3 tasks (Task 1: a simple operation by the dominant hand, Task 2: a simple operation using both hands, Task 3: a complicated operation using both hands) under 2-dimensionaland 3-dimensional systems. We tracked and recorded the motion of forceps tips with an optical marker captured by a 3-dimensional position tracker. We analyzed factors such as forceps path lengths, operation times, and technical errors for each task and compared the results of 2-dimensional and 3-dimensional monitors. Results. Mean operation times and technical errors were improved significantly for all tasks performed under the 3-dimensional system compared with the 2-dimensional system; in addition, mean path lengths for the forceps tips were shorter for all tasks performed under the 3-dimensional system. Conclusion. We found that stereoscopic images using a 3-dimensional monitor improved operative techniques with regard to increased accuracy and shorter path lengths for forceps movement, which resulted in a shorter operation time for basic phantom laparoscopic tasks. (Surgery 2017; 161:1334-40.)