AUTHOR=Sahm Maik , Danzer Clara , Grimm Alexis Leonhard , Herrmann Christian , Mantke Rene 

TITLE=Must Clinics Replace 2D by 3D Environments for an Efficient Training of Laparoscopic Novices? A Critical Analysis of the Learning Curve for Basic Skills

JOURNAL=Frontiers in Surgery

VOLUME=8

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.792107

DOI=10.3389/fsurg.2021.792107

ISSN=2296-875X

ABSTRACT=<sec><title>Background and Aims</title><p>Published studies repeatedly demonstrate an advantage of three-dimensional (3D) laparoscopic surgery over two-dimensional (2D) systems but with quite heterogeneous results. This raises the question whether clinics must replace 2D technologies to ensure effective training of future surgeons.</p></sec><sec><title>Methods</title><p>We recruited 45 students with no experience in laparoscopic surgery and comparable characteristics in terms of vision and frequency of video game usage. The students were randomly allocated to 3D (<italic>n</italic> = 23) or 2D (<italic>n</italic> = 22) groups and performed 10 runs of a laparoscopic “peg transfer” task in the Luebeck Toolbox. A repeated-measures ANOVA for operation times and a generalized linear mixed model for error rates were calculated. The main effects of laparoscopic condition and run, as well as the interaction term between the two, were examined.</p></sec><sec><title>Results</title><p>No statistically significant differences in operation times and error rates were observed between 2D and 3D groups (<italic>p</italic> = 0.10 and <italic>p</italic> = 0.72, respectively). The learning curve showed a significant reduction in operation time and error rates (both <italic>p</italic>'s &lt; 0.001). No significant interactions between group and run were detected (operation time: <italic>p</italic> = 0.342, error rates: <italic>p</italic> = 0.83). With respect to both endpoints studied, the learning curves reached their plateau at the 7th run.</p></sec><sec><title>Conclusion</title><p>The result of our study with laparoscopic novices revealed no significant difference between 2D and 3D technology with respect to performance time and the error rate in a simple standardized test. In the future, surgeons may thus still be trained in both techniques.</p></sec>