Comparative Evaluation of Laparoscopic Origami Crane Training With 3D and 2D Laparoscopy: Correlation With Fundamentals of Laparoscopic Surgery Scores

<i>Objective.</i> This prospective comparative study evaluated the efficacy and relationship between laparoscopic origami crane training (LOCT) and the Fundamentals of Laparoscopic Surgery (FLS) score using 3D vs 2D laparoscopy.<i>Methods.</i> From 2020 to 2023, fourth-year medical students at Asahikawa Medical University created 20 origami cranes (1 per day) in a laparoscopic dry box. FLS scores were assessed 5 times, corresponding to every fifth crane. Primary outcomes included LOCT production time, quality, and FLS scores, analyzed using the Mann-Whitney U test and repeated-measures ANOVA.<i>Results.</i> Eighteen participants were divided into 2 groups: 8 in the 3D laparoscopy (3D) group and ten in the 2D laparoscopy (2D) group. At the end of the study, the 3D group (16.5 min) produced cranes significantly faster than the 2D group (27 min, <i>P</i> = 0.02). Repeated-measures ANOVA showed that the production time, origami crane score, and FLS score improved over time. The 3D group had a significantly shorter production time (F (1, 16) = 8, <i>P</i> = 0.01). The origami crane score was not significantly different between the groups (F (1, 7) = 3, <i>P</i> = 0.13) but tended to be higher in the 3D group. No significant differences were found in the FLS scores between the groups for any task. A significant negative correlation between LOCT production time and FLS score in both groups confirmed that shorter production time correlated with higher FLS scores.<i>Conclusions.</i> LOCT is effective for extraclinical laparoscopic training and correlates with FLS scores. 3D laparoscopy may help beginners develop depth perception, improve bimanual and hand-eye coordination, and enhance LOCT effectiveness.