Depth cue reliance in surgeons and medical students

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Abstract
Background: Depth perception is reduced in endoscopic surgery, although little is known about the effect this has on surgical performance. Methods: To assess the role of depth cues, 45 subjects completed tests of depth cue reliance. Surgical skill was assessed using the Minimally Invasive Surgical Trainer-Virtual Reality, a previously validated laparoscopic simulator. Results: We could demonstrate no difference in cue reliance for three depth cues — namely stereo, texture, and outline — between surgeons and medical students. Greater dominance on stereo for medical students was a positive finding and a negative finding for the surgeons when correlated with surgical performance. Conclusions: We suggest that surgeons learn to adapt to the nonstereo environment in MIS, and this is the first study to show evidence of this phenomenon. This difference in stereo reliance is a reflection of the experience that surgeons have with laparoscopy compared with medical students, who have none.

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