Does a 3D image improve laparoscopic motor skills?

Aim: To quantitatively determine whether a three-dimensional (3D) image improves laparoscopic performance compared with a two-dimensional (2D) image. Method: This is a prospective study with two groups of participants: novices (5) and experts (5). Individuals within each group undertook a validated laparoscopic task on a box simulator, alternating between 2D and a 3D laparoscopic image until they had repeated the task five times with each imaging modality. A dedicated motion capture camera was used to determine the time taken to complete the task (seconds) and instrument distance traveled (meters). Results: Among the experts, the mean time taken to perform the task on the 3D image was significantly quicker than on the 2D image, 40.2 seconds versus 51.2 seconds, P < .0001. Among the novices, the mean task time again was significantly quicker on the 3D image, 56.4 seconds versus 82.7 seconds, P < .0001. There was no significant difference in the mean time it took a novice to perform the task using a 3D camera compared with an expert on a 2D camera, 56.4 seconds versus 51.3 seconds, P = .3341. Conclusion: The use of a 3D image confers a significant performance advantage over a 2D camera in quantitatively measured laparoscopic skills for both experts and novices. The use of a 3D image appears to improve a novice's performance to the extent that it is not statistically different from an expert using a 2D image.