Incidence and severity of Visually Induced motion Sickness during 3D laparoscopy In Operators who had No experience with it (VISION)

Aim
The aim of the study was to evaluate the incidence and severity of visually induced motion sickness (VIMS) during 3D laparoscopy, in operators without prior experience.

Material and methods
Design: A retrospective comparative study (Canadian Task Force classification II-2). Setting: A university hospital. Intervention: Gynecologic surgery. Main outcome measure: This is a prospective observational study, which enrolled 9 surgeons as participants. None of these surgeons had any prior experience with 3D laparoscopy. Each participant performed 10 consecutive cases of 3D laparoscopy in patients with benign or premalignant gynecological diseases. The primary outcome measure was the incidence and severity of VIMS, which was evaluated using the validated Simulator Sickness Questionnaire. Personal preferences, discomfort, and ease of 3D laparoscopy were also evaluated.

Results
Sixty-seven percent of surgeons experienced VIMS during their first 3D laparoscopy case. The incidence and severity of VIMS dramatically decreased from the second case onward. However, in some surgeons (22–44%), VIMS did not completely disappear until the tenth case. With respect to the discomfort using 3D laparoscopy, 84 self-reported responses after each surgery were “favor 3D laparoscopy,” and “no” in 61 (72.6%) and 47 (55.9%) participants, respectively. Most participants found it easier to perform 3D laparoscopy than 2D laparoscopy.

Conclusions
The occurrence of visually induced symptoms in susceptible individuals during 3D laparoscopy is high, particularly during their first case. This suggests the need for increasing surgeons’ awareness regarding the possibility of discomfort.