3D腹腔镜对初学者学习腹腔镜基本操作技能的有效性研究*

3D Laparoscopy promoted the novice surgeon's performance of laparoscopic surgical skills*

摘要:

目的   评估3D腹腔镜与2D普通腹腔镜在腹腔镜初学者学习腹腔镜基本技能时的影响。 方法   18名腹腔镜初学者采用最新的3D偏正立体显示腹腔镜系统依次完成4项基本腹腔镜操作试验，每项操作需重复8次，分别记录每次的完成时间和错误次数。结果  外科初学者在3D模式下与2D模式下相比，完成每项试验的平均时间和错误次数均明显下降，初学者采用3D系统完成整个试验的平均时间为3 343.24 s，采用2D系统则为4 151.88 s，采用3D系统使初学者的平均操作时间提高了19.47%。初学者采用3D系统的平均总错误率为77.41次，2D系统为138.64次，使用3D系统时初学者的错误率减少了44.16%。结论  先进的偏正3D腹腔镜系统明显提高了腹腔镜初学者学习腹腔镜基本操作技能的能力。

Abstract:

Objective To compare the last generation of 3-dimensional imaging (3D) vs standard 2-dimensional imaging (2D) laparoscopy on the effect of novice surgeon performance of minimally invasive surgical skills. Methods 18 novice surgeons performed 8 repetitions of 4 surgical skills tasks using a new passive polarising stereoscopic display under 3D and 2D conditions. The previously validated tasks used were pick beans, paper cut, pass the curved needle and knot tying. Outcome measures included total error rate and time for task completion. Results Novice surgeons demonstrated a significant reduction in error rates and a significant improvement in mean time for all the tasks using the 3D laparoscopy compared with the 2D laparoscopy. The mean time for novice surgeons to complete the entire protocol was 3343.24 s using 3D and 4151.88 s using 2D. This represents an improvement in mean performance time of 19.47% when novice surgeons used the 3D system compared with the 2D system. The mean number of errors performed by novice surgeons completing the entire protocol was 77.41 using 3D and 138.64 using 2D. This represents a 44.16% reduction in mean error rate when novice surgeons used the 3D system compared with the 2D system. Conclusion Passive polarising 3D displays significantly improve the novice surgeon performance during acquisition of laparoscopy surgical skills.