human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND PURPOSE Robotic surgery allows three-dimensional ( 3D ) viewing of tissues . We compared two-dimensional ( 2D ) and 3D suturing drills using the daVinci surgical system to determine if the latter is advantageous . MATERIAL S AND METHODS Twenty-eight anastomotic drills were completed by seven surgeons using the daVinci robot . Three surgeons had considerable ( > 6 months ) robotic experience , and four had none .  Drills were performed r and omly in both dimensional modes in a blinded fashion . Drill 1 was an interrupted four stitch and drill 2 a running closure . All tasks were kept uniform . We recorded time to completion , difficulty , and accuracy . The drills were evaluated by two independent review ers for accuracy and major errors ( i.e. , broken suture , torn graft ) . RESULTS The average operative time per drill in two dimensions was 13.1 minutes ( range 6.9 - 21.9 minutes ) and in three dimensions was 8.5 minutes ( range 4.7 - 12.8 minutes ) ( P<0.001 ) . Drill 1 was 6.1 minutes faster in three dimensions ( mean 9.2 minutes ; P<0.01 ) , and drill 2 was 2.9 minutes faster ( mean 7.8 minutes ; P=0.03 ) . Both advanced and novice groups were faster in 3D ( P<0.01 ) . There were two major errors in the 3D performances and 5 in the 2D exercises ( P<0.05 ) . The participants correctly identified the dimensional mode 92.9 % of the time ( P<0.01 ) . CONCLUSION The anastomosis was completed 65 % faster using 3D with equal , if not greater , accuracy . Drill 1 was improved to a greater degree than drill 2 , suggesting most benefit of 3D views during knot tying . Use of three dimensions outperformed two dimensions in both groups . Surgeons can immediately benefit from 3D viewing during robotic surgery OBJECTIVES Pure laparoscopic urologic surgery is becoming the st and ard of care for many urologic procedures . Training surgeons without any experience in the field is still a challenge . It is well recognized that two-dimensional optics causes difficulty for the novice . Thus , we assessed a new-generation , three-dimensional ( 3D ) visualization system . METHODS Fifteen laparoscopically novice surgeons were asked to perform five vali date d laparoscopic training exercises using the two-dimensional and 3D systems in r and om order : ( a ) linear cutting and suturing ; ( b ) curved cutting and suturing ; ( c ) tubular suturing ; ( d ) dorsal vein complex suturing simulation ; and ( e ) urethrovesical anastomosis . The objective ( time taken to complete the task versus the time needed by an expert ) and subjective ( accuracy on completion versus an expert 's ) scoring were performed independently by advanced laparoscopists . Statistical analysis was performed using the t test . RESULTS All tasks were completed by the participants . The statistical analysis revealed a trend toward improved task performance using 3D visualization . CONCLUSIONS Our preliminary testing has suggested that the new-generation , 3D system used will be helpful for developing skills in laparoscopy for the novice surgeon Background The increasing popularity of commercial movies showing three dimensional ( 3D ) images has raised concern about possible adverse side effects on viewers . Methods and Findings A prospect i ve carryover observational study was design ed to assess the effect of exposure ( 3D vs. 2D movie views ) on self reported symptoms of visually induced motion sickness . The st and ardized Simulator Sickness Question naire ( SSQ ) was self administered on a convenience sample of 497 healthy adult volunteers before and after the vision of 2D and 3D movies .  Viewers reporting some sickness ( SSQ total score>15 ) were 54.8 % of the total sample after the 3D movie compared to 14.1 % of total sample after the 2D movie .  Symptom intensity was 8.8 times higher than baseline after exposure to 3D movie ( compared to the increase of 2 times the baseline after the 2D movie ) . Multivariate modeling of visually induced motion sickness as response variables pointed out the significant effects of exposure to 3D movie  , history of car sickness and headache , after adjusting for gender , age , self reported anxiety level , attention to the movie and show time . Conclusions Seeing 3D movies can increase rating of symptoms of nausea , oculomotor and disorientation , especially in women with susceptible visual-vestibular system . Confirmatory studies which include examination of clinical signs on viewers are needed to pursue a conclusive evidence on the 3D vision effects on spectators BACKGROUND Several three-dimensional video-endoscopic systems have been introduced to enhance depth perception during minimum-access surgery . However , there is no conclusive evidence of benefit , and these systems are more expensive than conventional two-dimensional systems . We undertook a prospect i ve r and omised comparison of two-dimensional and three-dimensional imaging in elective laparoscopic cholecystectomy for symptomatic gallstone disease . METHODS The operations were done by four specialist registrars as part of their higher surgical training . 60 operations were r and omised for execution by either two-dimensional or three-dimensional imaging display ( 30 by each method ) . The degree of difficulty of the operation was grade d by a consultant surgeon on a st and ard grading system . The primary endpoints were execution time and the errors made during the procedure . The secondary endpoints were subjective assessment of the image quality and adverse effects on the surgeon . FINDINGS There was no difference between the two-dimensional and three-dimensional display groups in median execution time ( 3160 [ IQR 2735 - 4335 vs 3100 [ 2379 - 3710 ] s ; p = 0.2 ) or error rate ( six vs six ) . Surgeons reported adverse symptoms immediately after the operations with both systems . The scores for visual strain , headache , and facial discomfort were higher with the three-dimensional system . INTERPRETATION With the current technology , three-dimensional systems based on sequential imaging show no advantage over two-dimensional systems in the conduct of laparoscopic cholecystectomy Background Head-mounted display ( HM ) units are used in various industries , but they have been tried only recently in surgery . In this study , we evaluated whether a commercially available HMD would improve or impede a laparoscopic task — in this case , suturing . Methods Six participants performed a total of 120 laparoscopic suture knots in an experimental model . The Olympus FMD011 model with a two-dimensional image was used . The order of each task with or without the head display unit was r and om . The time to complete each knot was recorded , and the results were analyzed . Results The display unit prolonged the suturing times of the subjets by 10 % ( p<0.04 ) . Conclusions In this experimental model , the HMD we utilized did not appear to improve laparoscopic suturing . More developments , such as improved depth perception and better resolution , may increase its usefulness for laparoscopic tasks Abstract . Several three-dimensional ( 3-D ) video-endoscopic systems have been introduced in surgical practice to enhance depth perception during minimal access surgery ( MAS ) , but the facilitation of endoscopic manipulations by the current 3-D systems remains unproved . The aim of the study was to investigate the influence of 2-D and 3-D imaging modalities on intracorporeal suturing . The st and ard task consisted of suture closure of 60 mm enterotomies made in porcine small bowel with continuous seromuscular 3/0 Polysorb . Ten experienced surgeons participated in the study . The imaging systems were Storz ( 2-D ) , Welch Allyn ( 3-D ) , and Zeiss ( as both 2-D and 3-D ) . Each surgeon performed two tasks with each modality in a r and om sequence . The outcome measures were execution time , suture line leakage pressure , and suture placement score . In addition , the participating surgeons assigned subjective scores on the image quality and the adverse effects of the imaging systems . There was no significant difference in the execution time , leakage pressure , and suture placement score among the various imaging modalities . Depth perception was rated as similar with 2-D and 3-D imaging . Surgeons experienced visual strain with the three systems , but it was rated higher with 3-D imaging . With the current technology , we have not documented any significant difference in task efficiency and quality of endoscopic bowel suturing by trained surgeons between 2-D and 3-D imaging systems Purpose To compare task performances of novices and experts using advanced high-definition 3D versus 2D optical systems in a surgical simulator model . Methods Fifty medical students ( novices in laparoscopy ) were r and omly assigned to perform five st and ardized tasks adopted from the Fundamentals of Laparoscopic Surgery ( FLS ) curriculum in either a 2D or 3D laparoscopy simulator system . In addition , eight experts performed the same tasks . Task performances were evaluated using a vali date d scoring system of the SAGES/FLS program . Participants were asked to rate 16 items in a question naire . Results Overall task performance of novices was significantly better using stereoscopic visualization . Superiority of performances in 3D reached a level of significance for tasks peg transfer and precision cutting . No significant differences were noted in performances of experts when using either 2D or 3D . Overall performances of experts compared to novices were better in both 2D and 3D . Scorings in the question naires showed a tendency toward lower scores in the group of novices using 3D . Conclusions Stereoscopic imaging significantly improves performance of laparoscopic phantom tasks of novices . The current study confirms earlier data based on a large number of participants and a st and ardized task and scoring system . Participants felt more confident and comfortable when using a 3D laparoscopic system . However , the question remains open whether these findings translate into faster and safer operations in a clinical setting Background Common video systems for laparoscopy provide the surgeon a two-dimensional image ( 2D ) , where information on spatial depth can be derived only from secondary spatial depth cues and experience . Although the advantage of stereoscopy for surgical task efficiency has been clearly shown , several attempts to introduce three-dimensional ( 3D ) video systems into clinical routine have failed . The aim of this study is to evaluate users ’ performances in st and ardised surgical phantom model tasks using 3D HD visualisation compared with 2D HD regarding precision and working speed . Methods This comparative study uses a 3D HD video system consisting of a dual-channel laparoscope , a stereoscopic camera , a camera controller with two separate outputs and a wavelength multiplex stereoscopic monitor .  Each of 20 medical students and 10 laparoscopically experienced surgeons ( more than 100 laparoscopic cholecystectomies each ) pre-selected in a stereo vision test were asked to perform one task to familiarise themselves with the system and subsequently a set of five st and ardised tasks encountered in typical surgical procedures . The tasks were performed under either 3D or 2D conditions at r and om choice and subsequently repeated under the other vision condition . Predefined errors were counted , and time needed was measured . Results In four of the five tasks the study participants made fewer mistakes in 3D than in 2D vision . In four of the tasks they needed significantly more time in the 2D mode . Both the student group and the surgeon group showed similarly improved performance , while the surgeon group additionally saved more time on difficult tasks . Conclusions This study shows that 3D HD using a state-of-the-art 3D monitor permits superior task efficiency , even as compared with the latest 2D HD video systems Background Various studies have shown the benefit of three-dimensional ( 3D ) systems over two-dimensional ( 2D ) systems in laparoscopic surgery . However , a few studies have shown the impact of proficiency-based training and transferability of the skills from 2D to 3D system and vice versa . Purpose The purpose of this study was to investigate the impact of 2D and 3D environments on the time taken by novice trainees to learn basic laparoscopic skills and the transferability of the skills learnt in one environment to another . Methods Medical students with no prior experience in training of laparoscopic tasks were r and omly assigned to  2D or 3D groups . Both groups were trained in peg transfer and intracorporeal suture of Fundamentals of Laparoscopic Surgery ( FLS ) program until they attained predefined benchmarks . The practice times taken to reach the goal were compared . After they had reached the goal , all the participants were asked to repeat these tasks under both 2D and 3D environments . Their scores in both of the environments were compared . Results Eighty-eight participants were r and omly assigned to 2D ( n = 44 ) or 3D ( n = 44 ) training groups . There was no difference between the background s of both groups . The 3D training group was faster in reaching its goal in both tasks ( p < 0.001 and p = 0.007 , respectively ) . After reaching the goal , both groups were faster in the 3D environment in peg transfer ( p = 0.04 , p = 0.012 ) . In intracorporeal suture , the 2D training group had similar scores in both the environments ( p = 0.32 ) , but the 3D group was slower in the 2D environment ( p = < 0.001 ) . Conclusion The 3D environment helped shorten the training time of basic laparoscopic skills to novices . However , the novices trained in the 3D environment failed to transfer their skills to the 2D environment BACKGROUND This study was design ed to compare conventional laparoscopy with three-dimensional ( 3-D ) laparoscopy . METHOD Thirty c and i date s , 20 inexperienced and 10 experienced in operative laparoscopy  
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND PURPOSE Robotic surgery allows three-dimensional ( 3D ) viewing of tissues . We compared two-dimensional ( 2D ) and 3D suturing drills using the daVinci surgical system to determine if the latter is advantageous . MATERIAL S AND METHODS Twenty-eight anastomotic drills were completed by seven surgeons using the daVinci robot . Three surgeons had considerable ( > 6 months ) robotic experience , and four had none .  Drills were performed r and omly in both dimensional modes in a blinded fashion . Drill 1 was an interrupted four stitch and drill 2 a running closure . All tasks were kept uniform . We recorded time to completion , difficulty , and accuracy . The drills were evaluated by two independent review ers for accuracy and major errors ( i.e. , broken suture , torn graft ) . RESULTS The average operative time per drill in two dimensions was 13.1 minutes ( range 6.9 - 21.9 minutes ) and in three dimensions was 8.5 minutes ( range 4.7 - 12.8 minutes ) ( P<0.001 ) . Drill 1 was 6.1 minutes faster in three dimensions ( mean 9.2 minutes ; P<0.01 ) , and drill 2 was 2.9 minutes faster ( mean 7.8 minutes ; P=0.03 ) . Both advanced and novice groups were faster in 3D ( P<0.01 ) . There were two major errors in the 3D performances and 5 in the 2D exercises ( P<0.05 ) . The participants correctly identified the dimensional mode 92.9 % of the time ( P<0.01 ) . CONCLUSION The anastomosis was completed 65 % faster using 3D with equal , if not greater , accuracy . Drill 1 was improved to a greater degree than drill 2 , suggesting most benefit of 3D views during knot tying . Use of three dimensions outperformed two dimensions in both groups . Surgeons can immediately benefit from 3D viewing during robotic surgery OBJECTIVES Pure laparoscopic urologic surgery is becoming the st and ard of care for many urologic procedures . Training surgeons without any experience in the field is still a challenge . It is well recognized that two-dimensional optics causes difficulty for the novice . Thus , we assessed a new-generation , three-dimensional ( 3D ) visualization system . METHODS Fifteen laparoscopically novice surgeons were asked to perform five vali date d laparoscopic training exercises using the two-dimensional and 3D systems in r and om order : ( a ) linear cutting and suturing ; ( b ) curved cutting and suturing ; ( c ) tubular suturing ; ( d ) dorsal vein complex suturing simulation ; and ( e ) urethrovesical anastomosis . The objective ( time taken to complete the task versus the time needed by an expert ) and subjective ( accuracy on completion versus an expert 's ) scoring were performed independently by advanced laparoscopists . Statistical analysis was performed using the t test . RESULTS All tasks were completed by the participants . The statistical analysis revealed a trend toward improved task performance using 3D visualization . CONCLUSIONS Our preliminary testing has suggested that the new-generation , 3D system used will be helpful for developing skills in laparoscopy for the novice surgeon Background The increasing popularity of commercial movies showing three dimensional ( 3D ) images has raised concern about possible adverse side effects on viewers . Methods and Findings A prospect i ve carryover observational study was design ed to assess the effect of exposure ( 3D vs. 2D movie views ) on self reported symptoms of visually induced motion sickness . The st and ardized Simulator Sickness Question naire ( SSQ ) was self administered on a convenience sample of 497 healthy adult volunteers before and after the vision of 2D and 3D movies .  Viewers reporting some sickness ( SSQ total score>15 ) were 54.8 % of the total sample after the 3D movie compared to 14.1 % of total sample after the 2D movie .  Symptom intensity was 8.8 times higher than baseline after exposure to 3D movie ( compared to the increase of 2 times the baseline after the 2D movie ) . Multivariate modeling of visually induced motion sickness as response variables pointed out the significant effects of exposure to 3D movie  , history of car sickness and headache , after adjusting for gender , age , self reported anxiety level , attention to the movie and show time . Conclusions Seeing 3D movies can increase rating of symptoms of nausea , oculomotor and disorientation , especially in women with susceptible visual-vestibular system . Confirmatory studies which include examination of clinical signs on viewers are needed to pursue a conclusive evidence on the 3D vision effects on spectators BACKGROUND Several three-dimensional video-endoscopic systems have been introduced to enhance depth perception during minimum-access surgery . However , there is no conclusive evidence of benefit , and these systems are more expensive than conventional two-dimensional systems . We undertook a prospect i ve r and omised comparison of two-dimensional and three-dimensional imaging in elective laparoscopic cholecystectomy for symptomatic gallstone disease . METHODS The operations were done by four specialist registrars as part of their higher surgical training . 60 operations were r and omised for execution by either two-dimensional or three-dimensional imaging display ( 30 by each method ) . The degree of difficulty of the operation was grade d by a consultant surgeon on a st and ard grading system . The primary endpoints were execution time and the errors made during the procedure . The secondary endpoints were subjective assessment of the image quality and adverse effects on the surgeon . FINDINGS There was no difference between the two-dimensional and three-dimensional display groups in median execution time ( 3160 [ IQR 2735 - 4335 vs 3100 [ 2379 - 3710 ] s ; p = 0.2 ) or error rate ( six vs six ) . Surgeons reported adverse symptoms immediately after the operations with both systems . The scores for visual strain , headache , and facial discomfort were higher with the three-dimensional system . INTERPRETATION With the current technology , three-dimensional systems based on sequential imaging show no advantage over two-dimensional systems in the conduct of laparoscopic cholecystectomy Background Head-mounted display ( HM ) units are used in various industries , but they have been tried only recently in surgery . In this study , we evaluated whether a commercially available HMD would improve or impede a laparoscopic task — in this case , suturing . Methods Six participants performed a total of 120 laparoscopic suture knots in an experimental model . The Olympus FMD011 model with a two-dimensional image was used . The order of each task with or without the head display unit was r and om . The time to complete each knot was recorded , and the results were analyzed . Results The display unit prolonged the suturing times of the subjets by 10 % ( p<0.04 ) . Conclusions In this experimental model , the HMD we utilized did not appear to improve laparoscopic suturing . More developments , such as improved depth perception and better resolution , may increase its usefulness for laparoscopic tasks Abstract . Several three-dimensional ( 3-D ) video-endoscopic systems have been introduced in surgical practice to enhance depth perception during minimal access surgery ( MAS ) , but the facilitation of endoscopic manipulations by the current 3-D systems remains unproved . The aim of the study was to investigate the influence of 2-D and 3-D imaging modalities on intracorporeal suturing . The st and ard task consisted of suture closure of 60 mm enterotomies made in porcine small bowel with continuous seromuscular 3/0 Polysorb . Ten experienced surgeons participated in the study . The imaging systems were Storz ( 2-D ) , Welch Allyn ( 3-D ) , and Zeiss ( as both 2-D and 3-D ) . Each surgeon performed two tasks with each modality in a r and om sequence . The outcome measures were execution time , suture line leakage pressure , and suture placement score . In addition , the participating surgeons assigned subjective scores on the image quality and the adverse effects of the imaging systems . There was no significant difference in the execution time , leakage pressure , and suture placement score among the various imaging modalities . Depth perception was rated as similar with 2-D and 3-D imaging . Surgeons experienced visual strain with the three systems , but it was rated higher with 3-D imaging . With the current technology , we have not documented any significant difference in task efficiency and quality of endoscopic bowel suturing by trained surgeons between 2-D and 3-D imaging systems Purpose To compare task performances of novices and experts using advanced high-definition 3D versus 2D optical systems in a surgical simulator model . Methods Fifty medical students ( novices in laparoscopy ) were r and omly assigned to perform five st and ardized tasks adopted from the Fundamentals of Laparoscopic Surgery ( FLS ) curriculum in either a 2D or 3D laparoscopy simulator system . In addition , eight experts performed the same tasks . Task performances were evaluated using a vali date d scoring system of the SAGES/FLS program . Participants were asked to rate 16 items in a question naire . Results Overall task performance of novices was significantly better using stereoscopic visualization . Superiority of performances in 3D reached a level of significance for tasks peg transfer and precision cutting . No significant differences were noted in performances of experts when using either 2D or 3D . Overall performances of experts compared to novices were better in both 2D and 3D . Scorings in the question naires showed a tendency toward lower scores in the group of novices using 3D . Conclusions Stereoscopic imaging significantly improves performance of laparoscopic phantom tasks of novices . The current study confirms earlier data based on a large number of participants and a st and ardized task and scoring system . Participants felt more confident and comfortable when using a 3D laparoscopic system . However , the question remains open whether these findings translate into faster and safer operations in a clinical setting Background Common video systems for laparoscopy provide the surgeon a two-dimensional image ( 2D ) , where information on spatial depth can be derived only from secondary spatial depth cues and experience . Although the advantage of stereoscopy for surgical task efficiency has been clearly shown , several attempts to introduce three-dimensional ( 3D ) video systems into clinical routine have failed . The aim of this study is to evaluate users ’ performances in st and ardised surgical phantom model tasks using 3D HD visualisation compared with 2D HD regarding precision and working speed . Methods This comparative study uses a 3D HD video system consisting of a dual-channel laparoscope , a stereoscopic camera , a camera controller with two separate outputs and a wavelength multiplex stereoscopic monitor .  Each of 20 medical students and 10 laparoscopically experienced surgeons ( more than 100 laparoscopic cholecystectomies each ) pre-selected in a stereo vision test were asked to perform one task to familiarise themselves with the system and subsequently a set of five st and ardised tasks encountered in typical surgical procedures . The tasks were performed under either 3D or 2D conditions at r and om choice and subsequently repeated under the other vision condition . Predefined errors were counted , and time needed was measured . Results In four of the five tasks the study participants made fewer mistakes in 3D than in 2D vision . In four of the tasks they needed significantly more time in the 2D mode . Both the student group and the surgeon group showed similarly improved performance , while the surgeon group additionally saved more time on difficult tasks . Conclusions This study shows that 3D HD using a state-of-the-art 3D monitor permits superior task efficiency , even as compared with the latest 2D HD video systems Background Various studies have shown the benefit of three-dimensional ( 3D ) systems over two-dimensional ( 2D ) systems in laparoscopic surgery . However , a few studies have shown the impact of proficiency-based training and transferability of the skills from 2D to 3D system and vice versa . Purpose The purpose of this study was to investigate the impact of 2D and 3D environments on the time taken by novice trainees to learn basic laparoscopic skills and the transferability of the skills learnt in one environment to another . Methods Medical students with no prior experience in training of laparoscopic tasks were r and omly assigned to  2D or 3D groups . Both groups were trained in peg transfer and intracorporeal suture of Fundamentals of Laparoscopic Surgery ( FLS ) program until they attained predefined benchmarks . The practice times taken to reach the goal were compared . After they had reached the goal , all the participants were asked to repeat these tasks under both 2D and 3D environments . Their scores in both of the environments were compared . Results Eighty-eight participants were r and omly assigned to 2D ( n = 44 ) or 3D ( n = 44 ) training groups . There was no difference between the background s of both groups . The 3D training group was faster in reaching its goal in both tasks ( p < 0.001 and p = 0.007 , respectively ) . After reaching the goal , both groups were faster in the 3D environment in peg transfer ( p = 0.04 , p = 0.012 ) . In intracorporeal suture , the 2D training group had similar scores in both the environments ( p = 0.32 ) , but the 3D group was slower in the 2D environment ( p = < 0.001 ) . Conclusion The 3D environment helped shorten the training time of basic laparoscopic skills to novices . However , the novices trained in the 3D environment failed to transfer their skills to the 2D environment BACKGROUND This study was design ed to compare conventional laparoscopy with three-dimensional ( 3-D ) laparoscopy . METHOD Thirty c and i date s , 20 inexperienced and 10 experienced in operative laparoscopy  
    Output:
    