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Modern display technique seems to optimize visualization in minimal-invasive surgery. Many systems are available right now with a fundamental difference between the passive polarizing 3-dimensional (3D) and 2-dimensional (2D) technique. Data seems to show a benefit for the 3D technique in the visualization of the operative field. This could lead to more precision in minimal-invasive surgery. 2D-systems with high resolution of 4.096 x 2.180 pixels (4K) could be a promising alternative. This study wants to evaluate if 3D- or 4K- display technique could optimize surgeons´ view and improve the performance during minimal-invasive surgery. Therefore medical students and surgeons of different experience levels will perform surgical tasks on a minimal-invasive training system.They will be randomized to use first the 3D- or the 4K-display system in the training set-up. After completing the tasks with one system the minimal-invasive training set-up will be repeated with the other display system. NASA (National Aeronautics and Space Administration) task load index is evaluated after each round. The ability for stereoscopic vision is tested after finishing the complete training set-up with both systems. The primary outcome parameter surgical performance will be evaluated in this study defined as the performance time and the number of defined mistakes made during each task.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 3D-display system | Experimental | Subjects in this arm will perform the tasks on the minimal-invasive training set-up first with the 3D-display system. Then they will do the NASA task load index questionnaire. After that they will perform the tasks with the 4 K-display system. After that again a NASA Task load index questionnaire is performed. |
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| 4K-display system | Experimental | Subjects in this arm will perform the tasks on the minimal-invasive training set-up first with the 4K-display system. Then they will do the NASA task load index questionnaire. After that they will perform the tasks with the 3D-display system. After that again a NASA Task load index questionnaire is performed. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 3D-display system | Other | The subjects will perform tasks on a minimal-invasive/laparoscopic training set-up. They will perform the tasks with a 3D-display system or a 4K-display system. The intervention type 3D-display system means that the training-set up is performed first with 3D-display system an after that with the 4K-display system. |
| Measure | Description | Time Frame |
|---|---|---|
| Surgical Performance Time | The surgical performance time is defined as time needed to complete the tasks at the minimal-invasive trainer. the time is measured in seconds | immediately after tasks are performed, Day 1 |
| Surgical Performance Errors | it is measured once directly after completing the task with the 3D performance time and the number of errors: the surgical performance errors are defined as the number of defined errors made during the performance of the tasks at the minimal invasive trainer surgical performance errors = number of errors | immediately after tasks are performed, Day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Task Load | task load felt by the subjects evaluated by NASA task load index, after tasks with 3 D- and 4 K- systems are completed NASA task load index is evaluated once | immediately after tasks are performed, Day 1 |
| Learning curve |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Roger Wahba, MD, PhD | Universitätsklinikum Köln | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Cologne, Department of General, Visceral and Cancer Surgery | Cologne | 50931 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35869334 | Derived | Gietzelt C, Datta R, Busshoff J, Bruns T, Wahba R, Hedergott A. The influence of stereoscopic vision on surgical performance in minimal invasive surgery-a substudy of the IDOSP-Study (Influence of 3D- vs. 4 K-Display Systems on Surgical Performance in minimal invasive surgery). Langenbecks Arch Surg. 2022 Nov;407(7):3069-3078. doi: 10.1007/s00423-022-02608-3. Epub 2022 Jul 22. | |
| 31138290 |
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| 4K-display system | Other | The subjects will perform tasks on a minimal-invasive/laparoscopic training set-up. They will perform the tasks with a 3D-display system or a 4K-display system. The intervention type 4K-display system means that the training-set up is performed first with 4K-display system and after that with the 3D-display system. |
|
Learning curve after the completeness of the tasks
| immediately after tasks with both systems (3D and 4K) are performed, Day 1 |
| Stereoscopic view Bagolini | Qualitative test for assesment of stereoscopic view units : positive /negative/diplopia | immediately after tasks with both systems (3D and 4K) are performed, Day 1 |
| Stereoscopic view Lang I/II | Semi-quantitative test for assesment of stereoscopic view units : arc seconds | immediately after tasks with both systems (3D and 4K) are performed, Day 1 |
| Stereoscopic view Titmus | Semi-quantitative test for assesment of stereoscopic view units : arc seconds (fly at 3550 arc seconds, animals at 400, 200, 100 arc seconds,rings at 800, 400, 200, 140, 100, 80, 60, 50, 40 arc seconds) | immediately after tasks with both systems (3D and 4K) are performed, Day 1 |
| Stereoscopic view TNO | Semi-quantitative test for assesment of stereoscopic view units: arc seconds (480, 240, 120, 60, 30, 15) | immediately after tasks with both systems (3D and 4K) are performed, Day 1 |
| Stereoscopic view Cover | qualitative test for assesment of stereoscopic view units: phoria/tropia | immediately after tasks with both systems (3D and 4K) are performed, Day 1 |
| Derived |
| Wahba R, Datta RR, Hedergott A, Busshoff J, Bruns T, Kleinert R, Dieplinger G, Fuchs H, Gietzelt C, Moller D, Hellmich M, Bruns CJ, Stippel DL. 3D vs. 4K Display System - Influence of "State-of-the-art"-Display Technique On Surgical Performance (IDOSP-Study) in minimally invasive surgery: protocol for a randomized cross-over trial. Trials. 2019 May 28;20(1):299. doi: 10.1186/s13063-019-3330-7. |