Laparscopy
Video-assisted surgery represents more than a loss of three-dimensional vision

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Abstract

Background

Loss of depth cues is a major challenge facing surgeons performing video-assisted surgery (VAS). Whether the degradation of image quality from a video-displayed image plays a direct role in performance of VAS has not been studied.

Methods

Twenty-four volunteer novice subjects were randomized to binocular direct-vision (BDV), monocular direct-vision (MDV), or video-imaging (VI) conditions. Each subject completed ten trials of a simple cutting task in a box trainer using standard laparoscopic instruments.

Results

VI subjects made significantly fewer correct incisions than both of the other groups for all trials. Differences between the BDV and MDV groups did not reach statistical significance. Improvement in performance was more rapid in the BDV group than in either the MDV or VI groups.

Conclusions

The degradation of image quality with VI has a detrimental influence on VAS performance above and beyond the loss of binocular vision.

Section snippets

Subjects

Twenty-four medical students with no previous experience in MIS were randomly assigned to perform a validated [2], [3] basic MIS task under either binocular direct vision (BDV) (5 male, 3 females, mean age 21.5 years), monocular direct vision (MDV) (4 males, 4 females, mean age 22.9 years) with the nondominant eye covered by a simple elastic patch, or binocular VI (4 males, 4 females, mean age 23.3 years) conditions. Novices were selected to provide the purest comparison of imaging modalities

Results

Figure 1 shows the mean number of correct incisions made by the subjects in each group for the first, fifth, and tenth trials. Differences between the means of the groups were examined by using 2-factor analysis of variance for repeated measures where factor 1 was group and factor 2 was trials. To simplify analysis, trails 1, 5, and 10 were chosen to represent the trend in performance throughout the 10 trials. The results show that, for each trial, the BDV group made more correct incisions than

Comments

Understanding the results of this study requires a brief review of human visual perception [9]. When we view our environment, we rely on a variety of distance cues that allow us to interpret and determine the location of objects that we see in space. These cues can be divided into 2 main types: binocular cues, requiring stimulation of both eyes, and monocular cues, which do not change whether viewed by 1 or both eyes.

The binocular cue that is most important to perception is known as retinal

References (12)

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