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2D vs. 3D imaging in laparoscopic surgery—results of a prospective randomized trial

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Abstract

Purpose

3D imaging is an upcoming technology in laparoscopic surgery, and recent studies have shown that the modern 3D technique is superior in an experimental setting. However, the first randomized controlled clinical trial in this context dates back to 1998 and showed no significant difference between 2D and 3D visualization using the first 3D generation technique, which is now more than 15 years old.

Methods

Positive results measured in an experimental setting considering 3D imaging on surgical performance led us to initiate a randomized controlled pragmatic clinical trial to validate our findings in daily clinical routine. Standard laparoscopic operations (cholecystectomy, appendectomy) were preoperatively randomized to a 2D or 3D imaging system. We used a surgical comfort scale (Likert scale) and the Raw NASA Workload TLX for the subjective assessment of 2D and 3D imaging; the duration of surgery was also measured.

Results

The results of 3D imaging were statistically significant better than 2D imaging concerning the parameters “own felt safety” and “task efficiency”; the difficulty level of the procedures in the 2D and 3D groups did not differ. Overall, the Raw NASA Workload TLX showed no significance between the groups.

Conclusion

3D imaging could be a possible advantage in laparoscopic surgery. The results of our clinical trial show increased personal felt safety and efficiency of the surgeon using a 3D imaging system. Overall of the procedures, the findings assessed using Likert scales in terms of own felt safety and task efficiency were statistically significant for 3D imaging. The individually perceived workload assessed with the Raw NASA TLX shows no difference. Although these findings are subjective impressions of the performing surgeons without a clear benefit for 3D technology in clinical outcome, we think that these results show the capability that 3D laparoscopy can have a positive impact while performing laparoscopic procedures.

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Author information

Authors and Affiliations

  1. Department of General and Visceral Surgery, St. Elisabethen-Krankenhaus, Academic Teaching Hospital of Goethe University Frankfurt, Frankfurt, Germany

    Alexander Buia & Florian Stockhausen

  2. Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany

    Natalie Filmann

  3. Department of Visceral and Thoracic Surgery, Asklepios Klinik Langen, Academic Teaching Hospital, Goethe University Frankfurt, Langen, Germany

    Ernst Hanisch

Authors
  1. Alexander Buia
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  2. Florian Stockhausen
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  3. Natalie Filmann
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  4. Ernst Hanisch
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Contributions

Buia, A., Stockhausen, F., Filmann, N., and Hanisch, E. solely contributed to this paper.

Corresponding author

Correspondence to Alexander Buia.

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Technical support

The study was supported by the Olympus Corp., Hamburg, Germany.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Conflict of interest

The authors declare that they have no conflicts of interest.

Appendices

Appendix 1

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Appendix 2—NASA Task Load Index

figure b

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Buia, A., Stockhausen, F., Filmann, N. et al. 2D vs. 3D imaging in laparoscopic surgery—results of a prospective randomized trial. Langenbecks Arch Surg 402, 1241–1253 (2017). https://doi.org/10.1007/s00423-017-1629-y

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  • DOI: https://doi.org/10.1007/s00423-017-1629-y

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