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3D Versus 4K Display System - Influence of "State-of-the-art"-Display Technique on Surgical Performance (IDOSP-study) in Minimally Invasive Surgery: A Randomized Cross-over Trial.

ABSTRACT: OBJECTIVE:To evaluate if "state-of-the-art" 3D- versus 4K-display techniques could influence surgical performance. BACKGROUND:High quality minimally invasive surgery is challenging. Therefore excellent vision is crucial. 3D display technique (3D) and 2D-4K technique (4K) are designed to facilitate surgical performance, either due to spatial resolution (3D) or due to very high resolution (4K). METHODS:In randomized cross-over trial the surgical performance of medical students (MS), non-board certified surgeons (NBC), and board certified surgeons (BC) was compared using 3D versus 4K display technique at a minimally invasive training Parkour. RESULTS:One hundred twenty-eight participants were included (February 2018 through October 2019, 49 MS, 39 NBC, 40 BC). The overall Parkour time (s) 3D versus 4K was 712.5 s ± 17.5?s versus 999.5 s?±?25.1?s (P < 0.001) for all levels of experience. It was (3D vs 4K) for MS (30 tasks) 555.4 s?±?28.9?s versus 858.7 s?±?41.6?s, (P < 0.0001), for NBC (42 tasks) 935.9 s?±?31.5?s versus 1274.1 s?±?45.1?s (P?=< 0.001) and for BC (42 task) 646.3 s?±?30.9?s versus 865.7 s?±?43.7?s (P < 0.001). The overall number of mistakes was (3D vs 4K) 10.0?±?0.5 versus 13.3?±?0.7 (P < 0.001), for MS 8.9?±?0.9 versus 13.1?±?1.1 (P < 0.001), for NBC 12.45?±?1.0 versus 16.7?±?1.2 (P < 0.001) and for BC 8.8?±?1.0 versus 10.0?±?1.2 (P = 0.18). MS, BC, and NBC showed shorter performance time in 100% of the task with 3D (significantly in 6/7 tasks). For number of mistakes the effect was less pronounced for more experienced surgeons. The National Aeronautics and Space Administration-task load index was lower with 3D. CONCLUSION:3D laparoscopic display technique optimizes surgical performance compared to the 4K technique. Surgeons benefit from the improved visualization regardless of their individual surgical expertise.

SUBMITTER: Wahba R

PROVIDER: S-EPMC7553197 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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3D Versus 4K Display System - Influence of "State-of-the-art"-Display Technique on Surgical Performance (IDOSP-study) in Minimally Invasive Surgery: A Randomized Cross-over Trial.

Wahba Roger R Datta Rabi R Bußhoff Jana J Bruns Thomas T Hedergott Andrea A Gietzelt Caroline C Dieplinger Georg G Fuchs Hans H Morgenstern Bernd B Möller Desdemona D Hellmich Martin M Bruns Christiane J CJ Stippel Dirk L DL

Annals of surgery 20201101 5

<h4>Objective</h4>To evaluate if "state-of-the-art" 3D- versus 4K-display techniques could influence surgical performance.<h4>Background</h4>High quality minimally invasive surgery is challenging. Therefore excellent vision is crucial. 3D display technique (3D) and 2D-4K technique (4K) are designed to facilitate surgical performance, either due to spatial resolution (3D) or due to very high resolution (4K).<h4>Methods</h4>In randomized cross-over trial the surgical performance of medical student ...[more]

PMID: 32833763

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Project description:BackgroundThree-dimensional (3D) stereoscopic vision is crucial to perform any kind of manual task. The reduction from real life 3D to virtual two-dimensional (2D) sight is a major challenge in minimally invasive surgery (MIS). A 3D display technique has been shown to reduce operation time and mistakes and to improve the learning curve. Therefore, the use of a3D display technique seems to optimize surgical performance for novice and experienced surgeons. Inspired by consumer electronics, a 4K display technique was recently introduced to MIS. Due to its high resolution and zoom effect, surgeons should benefit from it. The aim of this study is to evaluate if "state-of-the-art" 3D- vs. 4K-display techniques could influence surgical performance.MethodsA randomized, cross-over, single-institution, single-blinded trial is designed. It compares the primary outcome parameter "surgical performance", represented by "performance time "and "number of mistakes", using a passive polarizing 3D and a 4K display system (two arms) to perform different tasks in a minimally invasive/laparoscopic training parkour. Secondary outcome parameters are the mental stress load (National Aeronautics and Space Administration (NASA) Task Load Index) and the learning curve. Unexperienced novices (medical students), non-board-certified, and board-certified abdominal surgeons participate in the trial (i.e., level of experience, 3 strata). The parkour consists of seven tasks (for novices, five tasks), which will be repeated three times. The 1st run of the parkour will be performed with the randomized display system, the 2nd run with the other one. After each run, the mental stress load is measured. After completion of the parkour, all participants are evaluated by an ophthalmologist for visual acuity and stereoscopic vision with five tests. Assuming a correlation of 0.5 between measurements per subject, a sample size of 36 per stratum is required to detect a standardized effect of 0.5 (including an additional 5% for a non-parametric approach) with a power of 80% at a two-sided type I error of 5%. Thus, altogether 108 subjects need to be enrolled.DiscussionComplex surgical procedures are performed in a minimally invasive/laparoscopic technique. This study should provide some evidence to decide which display technique a surgeon could choose to optimize his performance.Trial registrationClinicalTrials.gov, NCT03445429 . Registered on 7 February 2018.

Dataset Information

3D Versus 4K Display System - Influence of "State-of-the-art"-Display Technique on Surgical Performance (IDOSP-study) in Minimally Invasive Surgery: A Randomized Cross-over Trial.

Publications

3D Versus 4K Display System - Influence of "State-of-the-art"-Display Technique on Surgical Performance (IDOSP-study) in Minimally Invasive Surgery: A Randomized Cross-over Trial.

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