scholarly journals 3D- vs. 4K-Display System - Influence of "State-of-the-art"-Display Technique On Surgical Performance (IDOSP-Study) in minimal invasive surgery: protocol for a randomized cross-over trial

2018 ◽  
Author(s):  
Roger Wahba ◽  
Rabi R Datta ◽  
Andrea Hedergott ◽  
Jana Bußhoff ◽  
Thomas Bruns ◽  
...  
Keyword(s):  
Learning Curve ◽  
Invasive Surgery ◽  
Minimal Invasive Surgery ◽  
State Of The Art ◽  
Minimal Invasive ◽  
Stereoscopic Vision ◽  
Display System ◽  
Surgical Performance ◽  
Stress Load ◽  
Display Technique

Abstract Background: Three-dimensional (3D) stereoscopic vision is crucial to perform any kind of manual tasks. The reduction from real life 3D- to virtual two-dimensional (2D) sight is a major challenge in minimal invasive surgery (MIS). 3D-display technique has shown to reduce operation time, mistakes, and improve the learning curve. Therefore it seems to optimize surgical performance for novice and experienced surgeons. Inspired by consumer electronics 4K display technique was introduced to MIS recently. Due to its high resolution and zoom-effect surgeons should benefit from it. Aim of this study is to evaluate if “state-of-the-art” 3D- versus 4K- display techniques could influence surgical performance. Methods: A randomized cross-over single-institution single-blinded trial is designed. It compares the primary outcome parameter “surgical performance”, represented by “performance time “ and “number of mistakes” using a passive polarizing 3D- and a 4K-display system (2 arms) to perform different tasks in a minimal-invasive/laparoscopic training parkour. Secondary outcome parameters are the mental stress load (NASA task load index) and the learning curve. Unexperienced novices (medial students), non-board certified and board-certified abdominal surgeons participate in the trial (i.e. level of experience, 3 strata). The parkour consists of 7 tasks (novices 5 tasks), which will be repeated 3 times. The 1st run of the parkour will be performed with the randomized display system the 2nd with the other one. After each run metal stress load is measured. After completion of the parkour all participant are evaluated by an ophthalmologist for visual acuity and stereoscopic vision with five tests. A sample-size of 34 per stratum is required to detect a standardized effect of 0.5 with a power of 80% at two-sided type I error of 5%. Thus, altogether 102 subjects need to be enrolled. Discussion: Complex surgical procedures are performed in minimal invasive/laparoscopic technique. This study should provide some evidence to decide which display technique a surgeon could choose to optimize his performance. Trial Registration: This trial is registered at clinicaltrials.gov (trial number: NCT03445429, registered February 7, 2018, http://www.clinicaltrials.gov) Keywords: Minimal invasive surgery, laparoscopic, 3D, 4K, surgical performance, learning curve, surgical training

scholarly journals 3D- vs. 4K-Display System - Influence of "State-of-the-art"-Display Technique On Surgical Performance (IDOSP-Study) in minimal invasive surgery: protocol for a randomized cross-over trial

2019 ◽  
Author(s):  
Roger Wahba ◽  
Rabi R Datta ◽  
Andrea Hedergott ◽  
Jana Bußhoff ◽  
Thomas Bruns ◽  
...  
Keyword(s):  
Learning Curve ◽  
Mental Stress ◽  
Minimal Invasive Surgery ◽  
State Of The Art ◽  
Minimal Invasive ◽  
Stereoscopic Vision ◽  
Display System ◽  
Surgical Performance ◽  
Stress Load ◽  
Display Technique

Abstract Abstract Background Three-dimensional (3D) stereoscopic vision is crucial to perform any kind of manual tasks. The reduction from real life 3D- to virtual two-dimensional (2D) sight is a major challenge in minimal invasive surgery (MIS). 3D-display technique has shown to reduce operation time, mistakes, and to improve the learning curve. Therefore it seems to optimize surgical performance for novice and experienced surgeons. Inspired by consumer electronics 4K-display technique was recently introduced to MIS. Due to its high resolution and zoom-effect surgeons should benefit from it. Aim of this study is to evaluate if “state-of-the-art” 3D- versus 4K- display techniques could influence surgical performance. Methods A randomized cross-over single-institution single-blinded trial is designed. It compares the primary outcome parameter “surgical performance”, represented by “performance time “ and “number of mistakes”, using a passive polarizing 3D- and a 4K-display system (2 arms) to perform different tasks in a minimal invasive/laparoscopic training parkour. Secondary outcome parameters are the mental stress load (NASA task load index) and the learning curve. Unexperienced novices (medical students), non-board certified and board-certified abdominal surgeons participate in the trial (i.e. level of experience, 3 strata). The parkour consists of 7 tasks (novices 5 tasks), which will be repeated 3 times. The 1st run of the parkour will be performed with the randomized display system, the 2nd run with the other one. After each run, the mental stress load is measured. After completion of the parkour, all participants are evaluated by an ophthalmologist for visual acuity and stereoscopic vision with five tests. A sample-size of 36 per stratum is required to detect a standardized effect of 1.0 (including additional 5% for a non-parametric approach) with a power of 80% at two-sided type I error of 5%. Thus, altogether 108 subjects need to be enrolled. Discussion Complex surgical procedures are performed in minimal invasive/laparoscopic technique. This study should provide some evidence to decide which display technique a surgeon could choose to optimize his performance. Trial Registration This trial is registered at clinicaltrials.gov (trial number: NCT 03445429, registered February 7, 2018, http://www.clinicaltrials.gov)

scholarly journals 3D- vs. 4K-Display System - Influence of "State-of-the-art"-Display Technique On Surgical Performance (IDOSP-Study) in minimal invasive surgery: protocol for a randomized cross-over trial

2019 ◽  
Author(s):  
Roger Wahba ◽  
Rabi R Datta ◽  
Andrea Hedergott ◽  
Jana Bußhoff ◽  
Thomas Bruns ◽  
...  
Keyword(s):  
Learning Curve ◽  
Mental Stress ◽  
Minimal Invasive Surgery ◽  
State Of The Art ◽  
Minimal Invasive ◽  
Stereoscopic Vision ◽  
Display System ◽  
Surgical Performance ◽  
Stress Load ◽  
Display Technique

Abstract Background Three-dimensional (3D) stereoscopic vision is crucial to perform any kind of manual tasks. The reduction from real life 3D- to virtual two-dimensional (2D) sight is a major challenge in minimal invasive surgery (MIS). 3D-display technique has shown to reduce operation time, mistakes, and to improve the learning curve. Therefore it seems to optimize surgical performance for novice and experienced surgeons. Inspired by consumer electronics 4K-display technique was recently introduced to MIS. Due to its high resolution and zoom-effect surgeons should benefit from it. Aim of this study is to evaluate if “state-of-the-art” 3D- versus 4K- display techniques could influence surgical performance. Methods A randomized cross-over single-institution single-blinded trial is designed. It compares the primary outcome parameter “surgical performance”, represented by “performance time “ and “number of mistakes”, using a passive polarizing 3D- and a 4K-display system (2 arms) to perform different tasks in a minimal invasive/laparoscopic training parkour. Secondary outcome parameters are the mental stress load (NASA task load index) and the learning curve. Unexperienced novices (medical students), non-board certified and board-certified abdominal surgeons participate in the trial (i.e. level of experience, 3 strata). The parkour consists of 7 tasks (novices 5 tasks), which will be repeated 3 times. The 1st run of the parkour will be performed with the randomized display system, the 2nd run with the other one. After each run, the mental stress load is measured. After completion of the parkour, all participants are evaluated by an ophthalmologist for visual acuity and stereoscopic vision with five tests. Assuming a correlation of 0.5 between measurements per subject a sample-size of 36 per stratum is required to detect a standardized effect of 0.5 (including additional 5% for a non-parametric approach) with a power of 80% at two-sided type I error of 5%. Thus, altogether 108 subjects need to be enrolled. Discussion Complex surgical procedures are performed in minimal invasive/laparoscopic technique. This study should provide some evidence to decide which display technique a surgeon could choose to optimize his performance. Trial Registration This trial is registered at clinicaltrials.gov (trial number: NCT 03445429, registered February 7, 2018, http://www.clinicaltrials.gov)

scholarly journals 3D vs. 4K Display System - Influence of “State-of-the-art”-Display Technique On Surgical Performance (IDOSP-Study) in minimally invasive surgery: protocol for a randomized cross-over trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Roger Wahba ◽  
Rabi Raj Datta ◽  
Andrea Hedergott ◽  
Jana Bußhoff ◽  
Thomas Bruns ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Learning Curve ◽  
Mental Stress ◽  
State Of The Art ◽  
Stereoscopic Vision ◽  
Display System ◽  
Surgical Performance ◽  
Stress Load ◽  
Display Technique

Abstract Background Three-dimensional (3D) stereoscopic vision is crucial to perform any kind of manual task. The reduction from real life 3D to virtual two-dimensional (2D) sight is a major challenge in minimally invasive surgery (MIS). A 3D display technique has been shown to reduce operation time and mistakes and to improve the learning curve. Therefore, the use of a3D display technique seems to optimize surgical performance for novice and experienced surgeons. Inspired by consumer electronics, a 4K display technique was recently introduced to MIS. Due to its high resolution and zoom effect, surgeons should benefit from it. The aim of this study is to evaluate if “state-of-the-art” 3D- vs. 4K-display techniques could influence surgical performance. Methods A randomized, cross-over, single-institution, single-blinded trial is designed. It compares the primary outcome parameter “surgical performance”, represented by “performance time ”and “number of mistakes”, using a passive polarizing 3D and a 4K display system (two arms) to perform different tasks in a minimally invasive/laparoscopic training parkour. Secondary outcome parameters are the mental stress load (National Aeronautics and Space Administration (NASA) Task Load Index) and the learning curve. Unexperienced novices (medical students), non-board-certified, and board-certified abdominal surgeons participate in the trial (i.e., level of experience, 3 strata). The parkour consists of seven tasks (for novices, five tasks), which will be repeated three times. The 1st run of the parkour will be performed with the randomized display system, the 2nd run with the other one. After each run, the mental stress load is measured. After completion of the parkour, all participants are evaluated by an ophthalmologist for visual acuity and stereoscopic vision with five tests. Assuming a correlation of 0.5 between measurements per subject, a sample size of 36 per stratum is required to detect a standardized effect of 0.5 (including an additional 5% for a non-parametric approach) with a power of 80% at a two-sided type I error of 5%. Thus, altogether 108 subjects need to be enrolled. Discussion Complex surgical procedures are performed in a minimally invasive/laparoscopic technique. This study should provide some evidence to decide which display technique a surgeon could choose to optimize his performance. Trial registration ClinicalTrials.gov, NCT03445429. Registered on 7 February 2018.

scholarly journals Minimal invasive surgery of the spleen

2020 ◽  
Author(s):  
Áron Nyilas
Keyword(s):  
Learning Curve ◽  
Invasive Surgery ◽  
Minimal Invasive Surgery ◽  
Minimal Invasive ◽  
Hand Port

A laparoszkópos splenectomia 1991-es bevezetése óta gold standarddá lépett elő a lép sebészetében, és a nyitott műtéttel szembeni előnyei vitathatatlanok. Habár a műtéti idő jellemzően hosszabb LS esetén, viszont a splenectomiával öszefüggő morbiditás ritkább, és a posztoperatív hospitalizáció rövidebb. Az irodalomban igen korlátozott számban állnak rendelkezésre magyar betegpopuláción végzett vizsgálatok eredményei. A laparoszkópos lépsebészet 1994-ben került bevezetésre a Szegedi Tudományegyetem Sebészeti Klinikáján, és az azóta eltelt időben munkacsoportunk szerezte meg az egyik legnagyobb tapasztalatot a témában Magyarországon. Habár a laparoszkópos technikát kezdetben splenomegalia esetén kontraindikáltnak tartották, idővel bebizonyosodott a módszer biztonságossága extrém méretű lépek esetében is. Ahogy a laparoszkópos eljárás az extrém nagy méretű lépek esetében is elterjedt, felmerül az olykor 2000 grammnál is nagyobb tömegű specimen eltávolításának nehézsége. A szokásos eljárás a specimen Endobagbe helyezése, és valamelyik port helyén morcellációval történő eltávolítása. A kézzel asszisztált laparoszkópos splenectomia (HALS) esetén kézenfekvő a specimen hand-port helyén történő eltávolítása. Ezen eljárások mellett ismert a specimen Pfannenstiel-metszésből történő eltávolítása is. Irodalmi adatok alapján a lépméret mellet a learning curve bír még kiemelt jelentőséggel a splenectomia eredményeire. A splenectomia leggyakoribb indikációja az idiopátiás thrombocytopéniás purpura (ITP). Tekintettel az ITP immunológiai mechanizmusára, az első vonalbeli standard terápia kortikoszteroidok, illetve iv. immunglobulinok adása. Amennyiben a betegek az elsődleges kezelésre nem reagálnak, vagy a betegség reagál ugyan, de folyamatos gyógyszerelést igényel, refrakter ITP-ről beszélünk, mely miatt második vonalbeli kezelés jön szóba. Ez lehet Rituximab, TPO receptor agonisták, valamint a splenectomia, melyek közül a splenectomia biztosítja a legjobb és legtartósabb eredményt (80% körüli válasz, 60% 5-10 évig). A laparoszkópos eljárás számos előnye miatt évtizedek óta elfogadott sebészi módszer az ITP kezelésében. A módszer hematológiai eredményessége a hagyományos splenectomiához hasonló. Mindezek mellett csak nagyon korlátozott számban állnak rendelkezésre standardizált definiciókat és kimeneteli kritériumokat figyelembe vevő közlemények a splenectomia hosszú távú eredményeiről. Tekintettel arra, hogy a splenectomizált betegek mintegy 15-25 %-ánál nem vezet azonnali eredményre, illetve a betegek 1/3-a a későbbiekben relapszusba kerül, fontos lenne prediktív faktorok meghatározása a felesleges műtétek elkerülése, a terápia tervezhetősége érdekében. A splenectomia sikerességének megjóslására számos hipotetikus prediktív faktort vizsgáltak. Irodalmi adatok szólnak az életkor, a szteroid terápiára adott válasz, a perioperatív thrombocyta érték, valamint a thrombocyta sequestratio jellegének prediktív értékéről.

Minimal invasive surgery for intracardiac tumors – report of 19 consecutive patients

2010 ◽  
Vol 58 (S 01) ◽  
Author(s):  
T Bossert ◽  
P Krieg ◽  
T Sandhaus ◽  
P Kley-Madaus ◽  
K Hekmat
Keyword(s):  
Invasive Surgery ◽  
Minimal Invasive Surgery ◽  
Minimal Invasive ◽  
Intracardiac Tumors
Sign in / Sign up

Export Citation Format

Share Document