Background: Depth perception is reduced in endoscopic surgery, although little is known about the effect this has on surgical performance.
Methods: To assess the role of depth cues, 45 subjects completed tests of depth cue reliance. Surgical skill was assessed using the Minimally Invasive Surgical Trainer-Virtual Reality, a previously validated laparoscopic simulator.
Results: We could demonstrate no difference in cue reliance for three depth cues--namely stereo, texture, and outline--between surgeons and medical students. Greater dominance on stereo for medical students was a positive finding and a negative finding for the surgeons when correlated with surgical performance.
Conclusions: We suggest that surgeons learn to adapt to the nonstereo environment in MIS, and this is the first study to show evidence of this phenomenon. This difference in stereo reliance is a reflection of the experience that surgeons have with laparoscopy compared with medical students, who have none.