Aims:
Three-dimensional (3D) visualisation has been established for laparoscopy, but not
for endoluminal flexible endoscopy. In the actual study we investigated the effects
of 3D imaging on endoluminal endoscopic procedures.
Methods:
The study was conducted as an experimental endoscopic study in an ex-vivo porcine
stomach model. Artificial polyps were created by band ligation. For endoluminal polypectomy
a commercially available 3D laparoscope from Storz was inserted in a specially designed
tube with additional working channels for endoscopic instruments.
The task was to perform six polypectomies with two-dimensional (2D) and 3D visualisation
with an electric endoscopic snare in a prospective randomized cross-over manner. Participants
consisted of ten experts (group 1) and ten novices (group 2).
Duration and completeness were assessed. Before and after each visualisation method
the participants had to answer questionnaires and perform tests to evaluate their
concentration level and strain.
Results:
3D visualisation allowed for significantly faster polypectomy (3D vs. 2D: mean 27
s vs. 36 s; p = 0.029) and led to a significantly higher frequency of complete polypectomy
(3D vs. 2D: 106/120, 88% vs. 81/120, 68%; p < 0.01) in both groups.
Regarding overall workload, the NASA-Task-Load-Index showed similar figures for 3D
and 2D. According to the participants, 3D enabled significantly better depth perception
than 2D.
We noticed blurring at close distance for 3D and a tendency to cause higher eye strain.
Finally, most of the participants favoured the 3D visualisation.
Conclusions:
3D imaging may facilitate endoscopic procedures by improving speed and completeness.
We did not find increased mental workload and most of our participants preferred the
3D method. The difficulties concerning blurring at close distance could be alleviated
by technological progress. Therefore, the development of a flexible 3D endoscope seems
promising.
