The Impact of 3-D Video Endoscopy on Binocular Perception and Visually Guided Manipulation
Monocular video endoscopic systems are established in the clinical routine of surgical endoscopy. The introduction of 3-D video systems could improve visualisation of the intracorporal operating site because of the stereoscopic depth information. The goal of our investigations has been to quantify the influence of this visualisation technology on visual perception, on visually controlled endoscopic manipulations, and on the intraoperative performance, including ergonomic and psychophysical aspects. These results are used to define guidelines for improvement and for the integration of such systems into clinical routine so as to achieve optimal support of the medical team. The comparison of 2-D and 3-D video endoscopic systems showed a general improvement in the performance of endoscopic procedures. However, 30% – 50% of the users had perceptive problems with 3-D endoscopy. To study the problems quantitatively, we compared the case of stereoscopic visualisation with the real situation of direct view onto the specific objects. The users with problems had insufficient binocular depth perception of stereoscopic images for visual discrimination tasks, although their depth perception of real objects was good. Analysis of their eye movements showed significant differences compared with those of users with good binocular depth perception of stereo images. In particular, there were differences in the relation of vergence movements and accommodation. When we compared visually guided manipulations under stereoscopic video sight and direct view, we found the overall manipulative performance of all users to be the same, but the users with problems showed a lower performance in general. The experimental design and the results are discussed in detail.