Comparative study of two-dimensional and three-dimensional vision systems for minimally invasive surgery

Background: The aim of this comparative study was to gain subjective and objective data to determine for which operative tasks three-dimensional (3-D) vision systems are superior to two-dimensional (2-D) systems and to demonstrate any advantages or disadvantages of 3-D systems. Methods: A model with five standardized tasks including sewing and knotting was developed to objectively measure performance times and to count technical faults. In our training center for minimally invasive surgery, surgeons involved in basic and advanced laparoscopic courses trained using both 2-D and 3-D vision systems. They subsequently completed analog scale questionnaires to record a subjective impression of comparative ease of operation tasks under 2-D and 3-D vision and to identify perceived deficiencies in the 3-D system. Results: Compared to 2-D vision, the objective performance time was significantly shorter and significantly less mistakes were made using 3-D vision. All operative tasks were subjectively judged significantly easier under 3-D vision. Conclusions. Users with a normal capability for spatial perception can perform standard tasks more quickly and safely using 3-D vision, and a greater benefit is apparent for more complicated surgical maneuvers.