Operational effectiveness of three-dimensional flexible endoscopy: an ex vivo study using a new model

Surg Endosc. 2019 Nov;33(11):3612-3615. doi: 10.1007/s00464-018-06645-2. Epub 2019 Jan 7.

Abstract

Background and objectives: Two-dimensional (2D) images lack depth information and thus provide probabilistic recognition that do not completely match the actual three-dimensional (3D) information. Here, we investigated the operability of 3D endoscopes.

Methods: A 3D operation model was developed by passing 20 silk threads through upper and lower plates at 2-mm intervals in front and back rows separated by 1 mm. We evaluated accuracy and time of operating an electrosurgical knife. A successful operation was defined as pulling only a front-row thread; an unsuccessful operation was defined as pulling no thread (miss) or simultaneously pulling front- and back-row threads. Endoscopists (four experts, six trainees) repeated the operation under 2D and 3D conditions until individually accumulating 10 successful attempts under each condition.

Results: Operation accuracy was significantly higher for 3D compared with 2D in all endoscopists (88.5% vs. 61.3%; p < 0.01) and in both experience groups (trainees: 84.5% vs. 61.2%; experts: 95.2% vs. 61.5%; both p < 0.01). Operation time was significantly shorter for 3D compared with 2D in all endoscopists (12.5 ± 4.1 s vs. 14.8 ± 4.7 s; p < 0.01) and in both experience groups (trainees: 12.8 ± 4.2 s vs. 15.2 ± 4.9 s; experts: 12.1 ± 4.0 s vs. 14.3 ± 4.3 s; both p < 0.01).

Discussion: Compared with 2D endoscopy, 3D endoscopy significantly improved operation accuracy and shortened operation time, suggesting that 3D endoscopy enables accurate operation by depth information, aiding spatial recognition.

Keywords: 3D endoscope; Endoscopic procedure; Operation; Three-dimensional imaging (3D).

MeSH terms

  • Clinical Competence*
  • Endoscopes*
  • Equipment Design
  • Humans
  • Imaging, Three-Dimensional / instrumentation*
  • Imaging, Three-Dimensional / methods
  • Models, Anatomic*