2D-HD versus 3D endoscopy in endonasal skull base surgery: a comparative pre-clinical study.

2D-HD versus 3D endoscopy in endonasal skull base surgery: a comparative pre-clinical study.

World Neurosurg. 2017 May 31;:

Authors: Rampinelli V, Doglietto F, Mattavelli D, Qiu J, Raffetti E, Schreiber A, Villaret AB, Kucharczyk W, Donato F, Fontanella MM, Nicolai P

Abstract
BACKGROUND: Three-dimensional (3D) endoscopy has been recently introduced in endonasal skull base surgery. Only a relatively limited number of studies have compared it to two-dimensional, high definition (2D-HD) technology.
OBJECTIVE: To analyze, in a preclinical setting for endonasal endoscopic surgery, surgical maneuverability comparing 2D-HD and 3D endoscopy.
METHODS: A group of 68 volunteers, both novice and experienced surgeons, were asked to perform two tasks, namely simulating grasping and dissection surgical maneuvers, in a model of the nasal cavities. Time to complete the tasks was recorded. A questionnaire to investigate subjective feelings during tasks was filled by each participant. In 25 subjects, the surgeons' movements were continuously tracked by a magnetic based neuronavigator coupled with dedicated software (ApproachViewer - part of GTx-UHN) and the recorded trajectories were analyzed by comparing "jitter", "sum of square differences", and "funnel index".
RESULTS: Total execution time was significantly lower with 3D technology (p<0.05) in both beginners and experts. Questionnaires showed that beginners preferred 3D endoscopy more frequently than experts. A minority (14%) of beginners experienced discomfort with 3D endoscopy. Analysis of jitter showed a trend towards increased effectiveness of surgical maneuvers with 3D endoscopy. Sum of square differences and funnel index analyses documented better values with 3D endoscopy in experts.
CONCLUSIONS: In a pre-clinical setting for endonasal skull base surgery, 3D technology appears to confer an advantage in terms of time of execution and precision of surgical maneuvers.

PMID: 28578115 [PubMed - as supplied by publisher]

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