Surgery Today

, Volume 47, Issue 4, pp 440–444 | Cite as

Quantitative evaluation of 3D imaging in laparoscopic surgery

Original Article



3D images offer true depth perception, which overcomes one of the disadvantages of laparoscopic surgery. We evaluated differences in the use of 3D and 2D images in laparoscopic surgery based on the recording of traces of forceps.


Twelve surgeons at our hospital participated in the study. The task consisted of one suture and three ligations, using a training box. The completion time and number of hold errors were noted, and forceps traces were recorded using the Behavior Checker system (Miura Medical). Participants were divided into two groups based on faster and slower completion times with 2D images.


The median completion time in seconds (s) was significantly shorter when using 3D images than when using 2D images (51 s, range 34–146 vs. 63 s, range 38–265 s; p = 0.013). The 3D/2D completion time ratio was significantly higher in the faster 2D group (0.93 vs. 0.69, p = 0.030) indicating a greater effect of the 3D images on less experienced participants.


A quantitative evaluation showed that using 3D images enables more efficient use of laparoscopic forceps than 2D images. A system with 3D images is of particular benefit for inexperienced surgeons.


Laparoscopic surgery 3-Dimensional image Behavior Checker 



We thank Miura Medical for provision of the Behavior Checker and assistance with data analysis.

Compliance with ethical standards


Instrumentation supported by Miura Medical. Other funding from institutional sources only.

Conflict of interest

We have no conflicts of interest to declare.


  1. 1.
    Trastulli S, Cirocchi R, Listorti C, Cavaliere D, Avenia N, Gulla N, et al. Laparoscopic vs. open resection for rectal cancer: a meta-analysis of randomized clinical trials. Colorectal Dis. 2012;14:277–96.CrossRefGoogle Scholar
  2. 2.
    Hasegawa S, Nagayama S, Nomura A, Kawamura J, Sakai Y. Autonomic nerve-preserving total mesorectal excision in the laparoscopic era. Dis Colon Rectum. 2008;51:1279–82.CrossRefPubMedGoogle Scholar
  3. 3.
    Sakai Y, Nomura A, Masumori K, Kawamura J, Nagayama S. Recent interpretation of Denonvilliers’ fascia and the lateral ligament of the rectum. Asian J Endosc Surg. 2009;2:8–12.CrossRefGoogle Scholar
  4. 4.
    Ohtani H, Tamamori Y, Azuma T, Mori Y, Nishiguchi Y, Maeda K, et al. A meta-analysis of the short- and long-term results of randomized controlled trials that compared laparoscopy-assisted and conventional open surgery for rectal cancer. J Gastrointest Surg. 2011;15:1375–85.CrossRefPubMedGoogle Scholar
  5. 5.
    Hasegawa S, Hida K, Kawada K, Sakai Y. Laparoscopic surgery for rectal cancer (in Japanese with English abstract). J Jpn Soc Coloproctol. 2013;66:971–98.CrossRefGoogle Scholar
  6. 6.
    Mizushima T, Nakajima K, Takeyama H, Naito A, Osawa H, Uemura M, et al. Single-incision laparoscopic surgery for stricturing and penetrating Crohn’s disease. Surg Today. 2016;46:203–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Ikeda A, Fukunaga Y, Akiyoshi T, Konishi T, Fujimoto Y, Nagayama S, et al. Laparoscopic right colectomy in patients treated with previous gastrectomy. Surg Today. 2016;46:209–13.CrossRefPubMedGoogle Scholar
  8. 8.
    Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46:668–85.CrossRefPubMedGoogle Scholar
  9. 9.
    Katsuno H, Maeda K, Hanai T, Sato H, Masumori K, Koide Y, et al. Current status and future perspectives of robotic surgery for colorectal cancer (in Japanese with English abstract). J Jpn Soc Coloproctol. 2013;66:982–90.CrossRefGoogle Scholar
  10. 10.
    Hanai T, Maeda K, Katsuno H, Masumori K. Robotic surgery for colorectal cancer in Japan (in Japanese with English abstract). J JSCAS. 2014;16:51–5.Google Scholar
  11. 11.
    LaGrange CA, Clark CU, Gerber EW, Strup SE. Evaluation of three different laparoscopic modalities: robotics versus three-dimensional vision laparoscopy versus standard laparoscopy. J Endourol. 2008;22:511–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Alaraimi B, El Bakbak W, Sarker S, Makkiyah S, Al-Marzouq A, Goriparthi R, et al. A randomized prospective study comparing acquisition of laparoscopic skills in three-dimensional (3D) vs. two-dimensional (2D) laparoscopy. World J Surg. 2014;38:2746–52.CrossRefPubMedGoogle Scholar
  13. 13.
    Wilhelm D, Reiser S, Kohn N, Witte M, Leiner U, Muhlbach L, et al. Comparative evaluation of HD 2D/3D laparoscopic monitors and benchmarking to a theoretically ideal 3D pseudodisplay: even well-experienced laparoscopists perform better with 3D. Surg Endosc. 2014;28:2387–97.CrossRefPubMedGoogle Scholar
  14. 14.
    Cicione A, Autorino R, Breda A, De Sio M, Damiano R, Fusco F, et al. Three-dimensional vs standard laparoscopy: comparative assessment using a validated program for laparoscopic urologic skills. Urology. 2013;82:1444–50.CrossRefPubMedGoogle Scholar
  15. 15.
    Tanagho YS, Andriole GL, Paradis AG, Madison KM, Sandhu GS, Varela JE, et al. 2D versus 3D visualization: impact on laparoscopic proficiency using the fundamentals of laparoscopic surgery skill set. J Laparoendosc Adv Surg Tech A. 2012;22:865–70.CrossRefPubMedGoogle Scholar
  16. 16.
    Uemura M, Yamashita M, Tomikawa M, Obata S, Souzaki R, Ieiri S, et al. Objective assessment of the suture ligature method for the laparoscopic intestinal anastomosis model using a new computerized system. Surg Endosc. 2015;29:444–52.CrossRefPubMedGoogle Scholar
  17. 17.
    Harrysson IJ, Cook J, Sirimanna P, Feldman LS, Darzi A, Aqqarwal R. Systematic review of learning curves for minimally invasive abdominal surgery: a review of the methodology of data collection, depiction of outcomes, and statistical analysis. Ann Surg. 2014;260:37–45.CrossRefPubMedGoogle Scholar
  18. 18.
    Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P. Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg. 2004;91:146–50.CrossRefPubMedGoogle Scholar
  19. 19.
    Boyle E, Kennedy AM, Traynor O, Hill AD. Training surgical skills using nonsurgical tasks: can Nintendo Wii™ improve surgical performance? J Surg Educ. 2011;68:148–54.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Japan 2016

Authors and Affiliations

  1. 1.Colorectal and Pelvic Surgery DivisionNational Cancer Center Hospital EastChibaJapan
  2. 2.Center for Advanced Medical InitiativesKyushu UniversityFukuokaJapan

Personalised recommendations