Endoscopic training—is the future three‐dimensional?

BACKGROUND/OBJECTIVES: Endoscopic surgery has a distinct disadvantage compared to direct vision: loss of binocular vision. Three‐dimensional endoscopy has been welcomed due to the promise of improving stereopsis. METHODS: Prospective randomized study of junior doctors with minimal endoscopic experience, using both two‐dimensional and three‐dimensional, zero‐degree, 4‐mm Storz endoscopes. Data was collected using validated, standardized training models, both objectively and subjectively. Paired comparisons between variables relating to the endoscopes were performed using Wilcoxon's tests. Operators were then split into groups based on their endoscope preference, with comparisons made using Mann‐Whitney tests for Likert scale responses, Kendall's tau for ordinal variables, and Fisher's exact tests for nominal variables. RESULTS: Reduction of field of vision of three‐dimensional endoscopy by 2%. Significant findings included decreased past‐pointing, improved depth and perception and image quality. CONCLUSION: The use of an endoscopic endonasal approach with three‐dimensional technology has measurable advantages for novice users, and highlights potential tailoring of future surgical training LEVEL OF EVIDENCE: 1b