Brahmabhatt, Pranter1; Ahmed, Jake2; Denton, Oliver3; Sanu, Ameeth4
1 University Hospital of Wales, Cardiff and Vale UHB, Cardiff, UK;
2 Wrexham Maelor hospital, Betsi Cadwaladr UHB, Wrexham, UK;
3 Cardiff University School of Medicine, Cardiff, UK;
4 Morriston hospital, Abertawe Bro Morgannwg UHB, Swansea, UK.
The growing popularity of endoscopic ear surgery has led to concerns about the loss of 3-dimensional anatomical perception which the microscope would have previously provided.
We set out to ascertain whether a 3D endoscopic system offers any benefit over the traditional 2D technology.
A randomised trial was designed using 3D and 2D endoscope systems. First, volunteers were asked to describe anatomical relations in a labelled ‘ear model’. Next, participants used a laparoscopic box trainer with a single grasping instrument to perform simple tasks. Accuracy, speed and confidence were recorded during both exercises. Finally, participants were asked to express a preference for either system for each exercise. Participants were randomised in starting with either the 3D or 2D system, then performed the both study exercises before swapping endoscope type.
Data collected from 35 participants suggests reduced difficulty and increased confidence with anatomical recognition when using the 3D system. The 3D system appears to allow better recognition of the anatomical space despite only 56.5% of the volunteers choosing it over the 2D. The main criticisms were the need to wear 3D glasses, and distortion of the image if not located within a specific distance and orientation. For laparoscopic tasks, 90% preferred the 3D endoscope, and showed greater confidence with this over the 2D system.
The 3D system confers advantages over the 2D system in anatomical recognition and in simulated laparoscopic tasks. Factors extraneous to our defined outcome measures were most likely to affect participant preference in system for anatomical recognition.