{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:02:51Z","timestamp":1777921371092,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Various studies have shown the benefit of three-dimensional (3D) systems over two-dimensional (2D) systems in endoscopic surgery. However, few studies have focused on pediatric endosurgery. The purpose of this study was to assess the impact of 2D and 3D environments on the time taken and forceps manipulation by comparing experts and trainees using a laparoscopic hepaticojejunostomy simulator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We have developed a simulator of laparoscopic hepaticojejunostomy for congenital biliary dilatation. Seventeen participants of pediatric surgeons (4 experts and 13 trainees) performed hepaticojejunostomy using our simulator in both 2D and 3D environment. We evaluated the required time, total path length, and average velocities of bilateral forceps in both situations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Obtained results show the findings for the required time (seconds; 2D, experts: 810.43\u2009\u00b1\u2009321.64 vs. trainees: 1136.02\u2009\u00b1\u2009409.96,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.17) (seconds; 3D, experts: 660.21\u2009\u00b1\u2009256.48 vs. trainees: 1017\u2009\u00b1\u2009280.93,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.039), total path length of right forceps (mm; 2D, experts: 38838.23\u2009\u00b1\u200930686.63 vs. trainees: 52005.47\u2009\u00b1\u200931675.02,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.48)(mm; 3D, experts: 24443.09\u2009\u00b1\u200912316.32 vs. trainees: 45508.09\u2009\u00b1\u200926926.27,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.16), total path length of left forceps (mm; 2D, experts: 131635.54\u2009\u00b1\u200971669.94 vs. trainees: 245242.48\u2009\u00b1\u2009130940.25,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.48)(mm; 3D, experts: 88520.42\u2009\u00b1\u200956766.63 vs. trainees: 230789.75\u2009\u00b1\u2009107315.85,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.024), average velocities of right forceps (mm\/second; 2D, experts: 44.80\u2009\u00b1\u200921.85 vs. trainees: 44.37\u2009\u00b1\u200918.92,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.97) (mm\/second; 3D, experts: 37.28\u2009\u00b1\u200916.49 vs. trainees: 42.58\u2009\u00b1\u200914.40,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.54), average velocities of left forceps (mm\/second; 2D, experts: 156.65\u2009\u00b1\u200938.69 vs. trainees: 202.58\u2009\u00b1\u200963.80,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.20) (mm\/second; 3D, experts: 125.64\u2009\u00b1\u200944.30 vs. trainees: 219.42\u2009\u00b1\u200943.82,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The experts performed more effectively when using the 3D system. Using 3D, the total path length of the left forceps of expert pediatric surgeons was significantly shorter than trainee pediatric surgeons, and the average velocities of the left forceps tip of expert pediatric surgeons was significantly slower than trainee pediatric surgeons. These results suggest that training of assisting hand is necessary for advanced pediatric endosurgery to avoid organ injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lap.2019.0211","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T15:40:15Z","timestamp":1568994015000},"page":"1378-1382","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact and Characteristics of Forceps Manipulation of Three-Dimensional in Laparoscopic Hepaticojejunostomy Mimicking a Disease-Specific Simulator: A Comparison of Expert with Trainee"],"prefix":"10.1177","volume":"29","author":[{"given":"Koji","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."},{"name":"Clinical Training Center, Kagoshima University Hospital, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakazu","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."},{"name":"Clinical Training Center, Kagoshima University Hospital, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tokuro","family":"Baba","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshio","family":"Harumatsu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waka","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."},{"name":"Clinical Training Center, Kagoshima University Hospital, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuta","family":"Masuya","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiro","family":"Machigashira","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiko","family":"Nakame","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motoi","family":"Mukai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuru","family":"Kaji","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."},{"name":"Clinical Training Center, Kagoshima University Hospital, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Ieiri","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,10,14]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-015-1674-y"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5074-8"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2016.02.093"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-015-3776-y"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2014.0259"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5159-4"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-015-1227-y"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-017-4144-x"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-6169-1"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-010-2665-7"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2007.057190"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.04.044"}],"container-title":["Journal 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