Trends in 3-D Minimally Invasive Endoscopic Surgery

   Although the theory of minimally invasive surgery has been available for more than a century, it is only within the last 30 years that it has become accepted within the field. As a young field surrounded by ever expanding technological advances, there are many exciting developments in process and on the horizon. This article examines one of those developments, the advent of stereoscopic (3-D) endoscopy.

   This article begins by examining some of the most recent findings about the efficacy of 3-D endoscopy. It then discusses some of the unique challenges that are introduced by adopting this technology (challenges that are inherent to stereoscopic imaging as a whole, as well as some equipment specific challenges). Finally, it considers how the same trends that enable stereoscopic endoscopy may prove critical to another currently debated technique, natural orifice surgery (NOS, or scarless surgery).

   At first glance, introducing depth information to minimally invasive surgical procedures would seem to bring a host of benefits to those procedures. After all, surgeons work in a 3-D space within the patient, yet standard monitors show only a 2-D plane, requiring the surgeons to learn to interpret the nonstereo depth cues available to intuit the third dimension while performing surgeries.

   However, such a task is not unique to surgery. People are trained to do something similar when watching television or movies, a medium that asks us to understand a 3-D landscape via a 2-D display. As a whole, people are remarkably good at understanding gross-depth relationships even when presented on completely flat display surfaces.

   To understand why this is the case, we must consider that while there are fourteen cues that our brains use to determine depth and depth order, only three of these require stereoscopic vision. The other eleven cues can be determined and interpreted without left-eye/right-eye image disparity.

   What those eleven monoscopic cues don’t provide, however, is the ability to accurately judge distances between objects on the z-axis (such as judging how far ahead or behind an object is from another). Judging distances on the x- and y-axis in 2-D is fairly easy, as the objects on screen provide easy reference points to measure against one another, but there is very little depth information provided.

   "Trends in 3-D Minimally Invasive Endoscopic Surgery," (originally published at sibling site MD+DI), explores and explains the trends, technologies, and issues of this increasingly viable approach,a nd will bring you up-to-date on developments and oppportunities.

About the author

Shawn Veltman is Product Manager for Vancouver-based ISee3D Inc. The company develops proprietary 3-D image capture products based on a patented single lens technology. While the technology has direct application in several verticals, ISee3D is currently focused on the medical imaging space as it pertains specifically to the $9 billion annual expenditure in the areas of microscopy and endoscopy.

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