Surgeons Don 3D Glasses, Get 'Remarkable' Depth Perception for Keyhole Surgery: 3D 'Keyhole' Surgery Could Be Wave of Future

By Ubelacker, Sheryl | The Canadian Press, January 24, 2012 | Go to article overview

Surgeons Don 3D Glasses, Get 'Remarkable' Depth Perception for Keyhole Surgery: 3D 'Keyhole' Surgery Could Be Wave of Future


Ubelacker, Sheryl, The Canadian Press


TORONTO - It's a technology that had audiences for movies such as "Avatar" and "Harry Potter and the Deathly Hallows" virtually leaping out of their seats. And soon, that 3D sense of being in the centre of the action could go beyond the cinema to hospital operating rooms.

Several surgeons in Canada have test-run a prototype 3D system for laparoscopic surgeries, one form of the minimally invasive operations performed with a camera-tipped scope and instruments fed through tiny incisions in the body.

Conventional equipment allows the surgeon to see the patient's organs, blood vessels and other interior structures, and to manipulate instruments with the aid of a computer monitor. But the two-dimensional image is flat, similar to watching a broadcast on TV.

"With laparoscopic surgery, or any kind of minimally invasive surgery, we lose our tactile sense, so we only rely on visual cues," says Dr. Teodor Grantcharov, a general surgeon at St. Michael's Hospital in Toronto who specializes in gastric procedures.

"This has been one of the challenges with minimally invasive surgery, to convert the two-dimensional image which we see on a computer screen or monitor to a three-dimensional field, because we work in a three-dimensional field."

Some surgeons have great difficulty trying to manipulate delicate instruments inside a clearly three-dimensional body with the aid of only a two-dimensional image on a screen, he says. "And this visual perception has been a problem for many years, and that's been one of the limiting factors in laparoscopic surgery."

Indeed, a study by the hospital a few years ago found eight per cent of surgical trainees were unable to make the visual-spatial leap needed to master standard 2D laparoscopy.

"No matter how much they train, no matter how much they exercise, they will never be able to be proficient with laparoscopic techniques just because of this issue with visual perception," says Grantcharov.

Yet minimally invasive operations are often considered the standard of care, trumping traditional open surgery for many procedures. And the number of operations that can be performed with so-called "keyhole" surgery is growing.

"We've reached the point where there is no procedure that cannot be done laparoscopically and there is a lot of evidence that suggests that the laparoscopic approach is superior than the open (surgery)," Grantcharov says of operations involving the abdominal and pelvic areas.

For patients, the tiny incisions mean quicker healing, smaller scars and less post-operative time in hospital.

"The difference in recovery and quality of the procedure's success is spectacular," he says.

The 3D system could allow those doctors who are unable to visually navigate using the standard two-dimensional system to successfully perform minimally invasive surgeries, he believes.

Late last year, Grantcharov test-drove the prototype 3D system created by German-headquartered medical instrument company Karl Storz to perform a gastric bypass aimed at helping a patient lose weight. …

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