Virtuelle 3-D-Laparoskopie-Simulation in der chirurgischen Aus- und Weiterbildung – Ergebnisse einer Pilotstudie

Zusammenfassung

Hintergrund: Dem technischen Fortschritt folgend, werden im Operationssaal Module zur 3-dimensionalen Darstellung in der Laparoskopie eingesetzt. Erste Untersuchungen an Box-Trainern haben diskrepante Ergebnisse gezeigt. Für die Virtual-Reality-Laparoskopie (VRL) fehlen Daten zur 3-dimensionalen Simulation. Material und Methoden: 5 Fachärzte für Chirurgie, 10 chirurgisch tätige Ärzte in Weiterbildung und 29 Medizinstudenten führten abstrakte und prozedurale Übungen am VRL-Simulator im 2-D- und 3-D-Modus durch. Die Reihenfolge der Durchführung (2-D/3-D) wurde randomisiert. Ergebnisse: Für Ärzte und Studenten zeigten sich keine signifikanten Leistungsunterschiede für Übungen im 2-D- und 3-D-Durchgang. Die Präferenz des 3-D-Moduls war mit signifikant besseren Übungsergebnissen in beiden Durchgängen assoziiert. Diskussion: Einige Studien zur 3-D-Simulation an Box-Trainern ergaben Vorteile für unerfahrene Probanden gegenüber der 2-D-Simulation. Dies bestätigte sich in der vorliegenden Pilotstudie an einem VRL-Simulator nicht. Schlussfolgerung: Es konnte kein Vorteil der 3-D-Darstellung gegenüber der herkömmlichen 2-D-VRL-Simulation gezeigt werden.

Abstract

Background: The use of three-dimensional imaging in laparoscopy is a growing issue and has led to 3D systems in laparoscopic simulation. Studies on box trainers have shown differing results concerning the benefit of 3D imaging. There are currently no studies analysing 3D imaging in virtual reality laparoscopy (VRL). Materials and Methods: Five surgical fellows, 10 surgical residents and 29 undergraduate medical students performed abstract and procedural tasks on a VRL simulator using conventional 2D and 3D imaging in a randomised order. Results: No significant differences between the two imaging systems were shown for students or medical professionals. Participants who preferred three-dimensional imaging showed significantly better results in 2D as wells as in 3D imaging. Discussion: First results on three-dimensional imaging on box trainers showed different results. Some studies resulted in an advantage of 3D imaging for laparoscopic novices. This study did not confirm the superiority of 3D imaging over conventional 2D imaging in a VRL simulator. Conclusion: In the present study on 3D imaging on a VRL simulator there was no significant advantage for 3D imaging compared to conventional 2D imaging.

Schlüsselwörter

chirurgisches Training - minimalinvasive Chirurgie - Simulation - Virtual-Reality-Laparoskopie - 3-D-Simulation - chirurgische Technik

Key words

surgical training - minimally invasive surgery - simulation - virtual reality laparoscopy - 3D-simulation - surgical technique

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