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J Med Imaging (Bellingham). 2014 Apr;1(1):015001. doi: 10.1117/1.JMI.1.1.015001. Epub 2014 May 16.

Improved depth perception with three-dimensional auxiliary display and computer generated three-dimensional panoramic overviews in robot-assisted laparoscopy.

Journal of medical imaging (Bellingham, Wash.)

Fokko P Wieringa, Henri Bouma, Pieter T Eendebak, Jean-Paul A van Basten, Harrie P Beerlage, Geert A H J Smits, Jelte E Bos


  1. Netherlands Org. for Appl. Scientific Research TNO , P.O. Box 6235, 5600 HE Eindhoven, The Netherlands.
  2. Canisius Wilhelmina Hospital , P.O. Box 9015, 6500 GS Nijmegen, The Netherlands.
  3. Jeroen Bosch Hospital , P.O. Box 90153, 5200 ME 's-Hertogenbosch, The Netherlands.
  4. Rijnstate Hospital , P.O. Box 9555, 6800 TA Arnhem, The Netherlands.
  5. Netherlands Org. for Appl. Scientific Research TNO , P.O. Box 6235, 5600 HE Eindhoven, The Netherlands ; VU University Amsterdam , De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands.

PMID: 26158026 PMCID: PMC4479030 DOI: 10.1117/1.JMI.1.1.015001


In comparison to open surgery, endoscopic surgery offers impaired depth perception and narrower field-of-view. To improve depth perception, the Da Vinci robot offers three-dimensional (3-D) video on the console for the surgeon but not for assistants, although both must collaborate. We improved the shared perception of the whole surgical team by connecting live 3-D monitors to all three available Da Vinci generations, probed user experience after two years by questionnaire, and compared time measurements of a predefined complex interaction task performed with a 3-D monitor versus two-dimensional. Additionally, we investigated whether the complex mental task of reconstructing a 3-D overview from an endoscopic video can be performed by a computer and shared among users. During the study, 925 robot-assisted laparoscopic procedures were performed in three hospitals, including prostatectomies, cystectomies, and nephrectomies. Thirty-one users participated in our questionnaire. Eighty-four percent preferred 3-D monitors and 100% reported spatial-perception improvement. All participating urologists indicated quicker performance of tasks requiring delicate collaboration (e.g., clip placement) when assistants used 3-D monitors. Eighteen users participated in a timing experiment during a delicate cooperation task in vitro. Teamwork was significantly (40%) faster with the 3-D monitor. Computer-generated 3-D reconstructions from recordings offered very wide interactive panoramas with educational value, although the present embodiment is vulnerable to movement artifacts.

Keywords: 3-D visualization and 3-D reconstruction; endoscopic surgery; image guided procedures; image perception and observer performance; robot guided interventions


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