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Laparoscopic hysterectomy in the overweight and obese: does 3D imaging make a change?

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the influence of three-dimensional (3D) high-definition (HD) visualisation in laparoscopic hysterectomy in normal weight, overweight and obese women.

Methods

A retrospective analysis of 180 patients undergoing total laparoscopic hysterectomy (TLH: n = 90) or laparoscopic supracervical hysterectomy (LASH: n = 90) was performed. The study collective consisted of 90 women (TLH: n = 45, LASH: n = 45), who underwent laparoscopic hysterectomy with a 3D HD laparoscopic system. Ninety matched (uterine weight, previous surgeries) women with hysterectomy (TLH: n = 45, LASH: n = 45) performed by the same surgeon with conventional two-dimensional laparoscopy formed the control group. Statistical analysis was accomplished stratifying patients according to body mass index (BMI) (≤24.9, 25–29.9, ≥30.0 kg/m2). In each BMI, collective subtypes of surgery (TLH, LASH) as well as hysterectomies as a whole were analysed. Demographic data and surgical parameters were evaluated.

Results

In all BMI subgroups, there were no significant differences concerning demographic parameters. Number of trocar site incisions needed was significantly less in women undergoing 3D compared to 2D laparoscopy independent of BMI. Furthermore, a significantly lower blood loss was revealed using 3D visualisation in LASH subgroups of the normal and overweight collectives. Three-dimensional laparoscopy was additionally associated with a significantly shorter duration of surgery in the TLH subgroup in overweight patients and a lower haemoglobin drop in the LASH subgroup of the obese.

Conclusion

The need of less trocar site incisions concerning all weight groups as well.

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References

  1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DF, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SE, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KM, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJ, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJ, Gakidou E (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384(9945):766–781. doi:10.1016/S0140-6736(14)60460-8

    Article  PubMed  PubMed Central  Google Scholar 

  2. Morgan-Ortiz F, Soto-Pineda JM, Lopez-Zepeda MA, Peraza-Garay Fde J (2013) Effect of body mass index on clinical outcomes of patients undergoing total laparoscopic hysterectomy. Int J Gynaecol Obstet 120(1):61–64. doi:10.1016/j.ijgo.2012.08.012

    Article  PubMed  Google Scholar 

  3. Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BW, Kluivers KB (2015) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 8:CD003677. doi:10.1002/14651858.CD003677.pub5

    Google Scholar 

  4. Osler M, Daugbjerg S, Frederiksen BL, Ottesen B (2011) Body mass and risk of complications after hysterectomy on benign indications. Hum Reprod 26(6):1512–1518. doi:10.1093/humrep/der060

    Article  PubMed  Google Scholar 

  5. Blikkendaal MD, Schepers EM, van Zwet EW, Twijnstra AR, Jansen FW (2015) Hysterectomy in very obese and morbidly obese patients: a systematic review with cumulative analysis of comparative studies. Arch Gynecol Obstet 292(4):723–738. doi:10.1007/s00404-015-3680-7

    Article  PubMed  PubMed Central  Google Scholar 

  6. Garry R, Fountain J, Brown J, Manca A, Mason S, Sculpher M, Napp V, Bridgman S, Gray J, Lilford R (2004) EVALUATE hysterectomy trial: a multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health Technol Assess 8(26):1–154

    Article  CAS  PubMed  Google Scholar 

  7. Eltabbakh GH, Piver MS, Hempling RE, Recio FO (1999) Laparoscopic surgery in obese women. Obstet Gynecol 94(5 Pt 1):704–708

    CAS  PubMed  Google Scholar 

  8. Honeck P, Wendt-Nordahl G, Rassweiler J, Knoll T (2012) Three-dimensional laparoscopic imaging improves surgical performance on standardized ex vivo laparoscopic tasks. J Endourol 26(8):1085–1088. doi:10.1089/end.2011.0670

    Article  PubMed  Google Scholar 

  9. Kong SH, Oh BM, Yoon H, Ahn HS, Lee HJ, Chung SG, Shiraishi N, Kitano S, Yang HK (2010) Comparison of two- and three-dimensional camera systems in laparoscopic performance: a novel 3D system with one camera. Surg Endosc 24(5):1132–1143. doi:10.1007/s00464-009-0740-8

    Article  PubMed  Google Scholar 

  10. Taffinder N, Smith SG, Huber J, Russell RC, Darzi A (1999) The effect of a second-generation 3D endoscope on the laparoscopic precision of novices and experienced surgeons. Surg Endosc 13(11):1087–1092

    Article  CAS  PubMed  Google Scholar 

  11. Wagner OJ, Hagen M, Kurmann A, Horgan S, Candinas D, Vorburger SA (2012) Three-dimensional vision enhances task performance independently of the surgical method. Surg Endosc 26(10):2961–2968. doi:10.1007/s00464-012-2295-3

    Article  CAS  PubMed  Google Scholar 

  12. Tuschy B, Berlit S, Brade J, Sutterlin M, Hornemann A (2014) Full high-definition three-dimensional gynaecological laparoscopy–clinical assessment of a new robot-assisted device. Vivo 28(1):111–115

    Google Scholar 

  13. Kuczmarski RJ, Carroll MD, Flegal KM, Troiano RP (1997) Varying body mass index cutoff points to describe overweight prevalence among U.S. adults: NHANES III (1988–1994). Obes Res 5(6):542–548

    Article  CAS  PubMed  Google Scholar 

  14. Becker H, Melzer A, Schurr MO, Buess G (1993) 3-D video techniques in endoscopic surgery. Endosc Surg Allied Technol 1(1):40–46

    CAS  PubMed  Google Scholar 

  15. Köster S, Volz J, Melchert F (1996) Indication for 3D laparoscopy in gynaecology. Geburtshilfe Frauenheilkd 56:431–433

    Article  PubMed  Google Scholar 

  16. van Bergen P, Kunert W, Buess GF (2000) The effect of high-definition imaging on surgical task efficiency in minimally invasive surgery: an experimental comparison between three-dimensional imaging and direct vision through a stereoscopic TEM rectoscope. Surg Endosc 14(1):71–74

    Article  PubMed  Google Scholar 

  17. Buchs NC, Volonte F, Pugin F, Toso C, Morel P (2012) Three-dimensional laparoscopy: a step toward advanced surgical navigation. Surg Endosc. doi:10.1007/s00464-012-2481-3

    Google Scholar 

  18. Storz P, Buess GF, Kunert W, Kirschniak A (2012) 3D HD vs. 2D HD: surgical task efficiency in standardised phantom tasks. Surg Endosc 26(5):1454–1460. doi:10.1007/s00464-011-2055-9

    Article  PubMed  Google Scholar 

  19. Sorensen SM, Savran MM, Konge L, Bjerrum F (2016) Three-dimensional vs. two-dimensional vision in laparoscopy: a systematic review. Surg Endosc 30(1):11–23. doi:10.1007/s00464-015-4189-7

    Article  PubMed  Google Scholar 

  20. Kaufman Y (2007) The three-dimensional “insect eye” laparoscopic imaging system—a prospective randomized study. Gynecol Surg 4:31–34

    Article  Google Scholar 

  21. Usta TA, Karacan T, Naki MM, Calik A, Turkgeldi L, Kasimogullari V (2014) Comparison of 3-dimensional vs. 2-dimensional laparoscopic vision system in total laparoscopic hysterectomy: a retrospective study. Arch Gynecol Obstet 290(4):705–709. doi:10.1007/s00404-014-3253-1

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Sebastian Berlit, Amadeus Hornemann, Marc Sütterlin & Benjamin Tuschy

  2. Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Christel Weiss

Authors
  1. Sebastian Berlit
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  2. Amadeus Hornemann
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  3. Marc Sütterlin
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  4. Christel Weiss
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  5. Benjamin Tuschy
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Correspondence to Sebastian Berlit.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Berlit, S., Hornemann, A., Sütterlin, M. et al. Laparoscopic hysterectomy in the overweight and obese: does 3D imaging make a change?. Arch Gynecol Obstet 295, 125–131 (2017). https://doi.org/10.1007/s00404-016-4215-6

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  • DOI: https://doi.org/10.1007/s00404-016-4215-6

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