Abstract
Minimally invasive surgery has evolved over the last century to become a gold standard for many surgical procedures. This relates to the reduction in morbidity associated with large incisions. Patients benefit from reduced surgical trauma and post-operative pain, and a more rapid recovery and return to normal activities. This is at the cost of an increased complexity of technical skill required and therefore steep learning curve, especially related to the loss of the stereopsis of binocular vision, which provides our keenest depth perception in dextrous skills. Technological pioneers have been trying to overcome the loss of stereopsis for the last few decades without success, either from poor image capture or projection technologies. The advent of passive polarising 3D technology in the entertainment industry has paved the way for new visual systems which, in laboratory based experiments, have shown significant benefits to efficiency in tasks with reduced time and error production. These benefits have yet to be proven in true surgery with any validity. This research was undertaken to provide high quality evidence investigating the effect of these 3D visual systems on actual laparoscopic surgery. The aim was to evaluate whether the benefits to surgical efficiency, and potentially patient safety with error reduction, are truly transferrable to the complex environment of an operating theatre. Although the reduction in operative time showed no significance with the primary end point, sub group analysis identified significant benefit in more difficult cases. The study shows that the 3D systems do reduce the operating time and the significant error production, especially gallbladder perforation, in true surgery.