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Introduction: While there is an increasing demand for minimally invasive operative techniques in Ear, Nose and Throat
surgery, these operations are difficult to learn for junior doctors and demanding to supervise for experienced surgeons.
The motivation for this study was to integrate high-definition (HD) stereoscopic video monitoring in microscopic
surgery in order to facilitate teaching interaction between senior and junior surgeon.
Material and methods: We attached a 1280x1024 HD stereo camera (TrueVisionSystemsTM Inc., Santa Barbara, CA,
USA) to an operating microscope (Zeiss ProMagis, Zeiss Co., Oberkochen, Germany), whose images were processed
online by a PC workstation consisting of a dual Intel® Xeon® CPU (Intel Co., Santa Clara, CA). The live image was
displayed by two LCD projectors @ 1280x768 pixels on a 1,25m rear-projection screen by polarized filters. While the
junior surgeon performed the surgical procedure based on the displayed stereoscopic image, all other participants (senior
surgeon, nurse and medical students) shared the same stereoscopic image from the screen.
Results: With the basic setup being performed only once on the day before surgery, fine adjustments required about 10
minutes extra during the operation schedule, which fitted into the time interval between patients and thus did not prolong
operation times. As all relevant features of the operative field were demonstrated on one large screen, four major effects
were obtained: A) Stereoscopy facilitated orientation for the junior surgeon as well as for medical students. B) The
stereoscopic image served as an unequivocal guide for the senior surgeon to demonstrate the next surgical steps to the
junior colleague. C) The theatre nurse shared the same image, anticipating the next instruments which were needed. D)
Medical students instantly share the information given by all staff and the image, thus avoiding the need for an extra
teaching session.
Conclusion: High definition stereoscopy bears the potential to compress the learning curve for undergraduate as well as
postgraduate medical professionals in minimally invasive surgery. Further studies will focus on the long term effect for
operative training as well as on post-processing of HD stereoscopy video content for off-line interactive medical
education.
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