gms | German Medical Science

Introduction: Laparoscopic as compared to open surgery represents some specific challenges, such as the reduction of a three-dimensional anatomic environment to two dimensions. Individuals with permanent impaired stereopsis may be better adapted to the lost third dimension on the screen in laparoscopic surgery. The aim of this study is to investigate the impact of stereopsis on performance in a laparoscopic virtual reality (VR) simulator.

Material and methods: We compared a group with impaired (group 1, n=28) to a group with accurate stereopsis (group 2, n=29) performing tasks on the Simbionix^TM VR laparoscopy simulator using LAP Mentor^TM software. Primary outcome was the difference between both groups measuring the mean total score (MTS) (standardised average of all tasks) and the performance in task 3, which was a priori considered to be the most depending on intact stereopsis. Secondary outcome was the difference between a second run with an eye pad (simulating impaired stereopsis) in participants with accurate stereopsis (group 2) and the first run without eye pad.

Results: MTS and performance in task 3, adjusted for age and near visual acuity (NVA), tended to be slightly, but not significantly better in group 2 than in group 1 (MTS: -0.12 (95% CI -0.32, 0.08; p=0.234); task 3: -0.09 (95% CI -0.29, 0.11; p=0.385)).The difference between simulated impaired stereopsis in group 2 and the first run was not significantly different (MTS: p=0.981; task 3: p=0.527).

Conclusion: We were unable to demonstrate an advantage of impaired stereopsis in laparoscopic performance on a VR simulator. Individuals with accurate stereopsis seem to be able to compensate the loss of the third dimension in laparoscopic surgery.