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Three-Dimensional (3D) Versus Two-Dimensional (2D) Laparoscopic Bariatric Surgery: a Single-Surgeon Prospective Randomized Comparative Study

Abstract

Background

To address the issue whether three-dimensional (3D) offers real operative time advantages to the laparoscopic surgical procedure, we have designed a single-surgeon prospective randomized comparison of 3D versus two-dimensional (2D) imaging during two different bariatric procedures.

Methods

Forty morbidly obese patients were randomized on the day of surgery by a random computer-generated allocation list to receive either a 3D high-definition (HD) display or 2D HD imaging system laparoscopic bariatric procedure by a single experienced surgeon. Forty operations were performed with either a 3D HD display or 2D HD imaging system. After the insertion of the access ports, both surgical procedures were divided in component tasks, and the execution times were compared.

Results

The execution times for the entire procedure and the single tasks were not significantly different between the 2D and 3D groups during sleeve gastrectomy. The execution times for the entire procedure and the single tasks, except for the first one, were significantly different between the 2D and 3D groups during mini-gastric bypass (p < 0.05). The surgeon experienced better depth perception with the 3D system and subjectively reported less strain using 3D vision system rather than the 2D system particularly during longer procedure.

Conclusions

3D imaging seems to decrease the performance time of more difficult bariatric procedures, which involve surgical tasks as suturing and intestinal measurement. Further comparative studies are necessary to address the issue if novice surgeons could benefit from reduced learning curve requested with 3D vision and to verify with greater numbers if 3D imaging can reduce complications.

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References

  1. Sinha R, Sundaram M, Raje S, et al. 3D laparoscopic: technique and initial experience in 451 cases. GynecolSurg. 2013;10:123–8.

    Google Scholar 

  2. Buchwald M, Oien MD. Metabolic/bariatric surgery worldwide 2011. ObesSurg. 2013;23:427–36.

    Google Scholar 

  3. Van Bergen P, Kunert W, Bessell J, et al. Comparative study of 2D and 3D vision systems for minimally invasive surgery. SurgEndosc. 1998;12:948–54.

    Google Scholar 

  4. Hanna GB, Shimi SM, Cuschieri A. Randomised study of influence of two-dimensional versus three-dimensional imaging on performance of laparoscopic cholecystectomy. Lancet. 1998;351:248–51.

    CAS  Article  PubMed  Google Scholar 

  5. Melissas J. IFSO guidelines for safety, quality and excellence in bariatric surgery. Obes Surg. 2008;18:497–500.

    Article  PubMed  Google Scholar 

  6. Lee WJ, Lin YH. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg. 2014;24:1749–56.

    Article  PubMed  Google Scholar 

  7. Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. SurgEndosc. 2006;20:859–63.

    CAS  Google Scholar 

  8. de Tavares de MenezesEttinger JEM, dos Santos Filho PV, Azaro E, et al. Prevention of rhabdomyolysis in bariatric surgery. Obesity Surg. 2005;15:874–9.

    Article  Google Scholar 

  9. Qaseem A, Snow V, Fittermann N, et al. Risk assessment for and strategies to reduce perioperative pulmonary complications for patients undergoing noncardiothoracic surgery: a guideline from the American College of Physician. Ann Intern Med. 2006;144:575–80.

    Article  PubMed  Google Scholar 

  10. Narani KK. Deep vein thrombosis and pulmonary embolism—prevention, management, and anaesthetics consideration. Indian J Anaesth. 2010;54(1):8–17.

    PubMed Central  Article  PubMed  Google Scholar 

  11. Diwakar S, Mittu JM, Prasanna KR. 3D laparoscopy—help or hype; initial experience of a tertiary health centre. J Clin Diag Res. 2014;8(7):NC01–3.

    Google Scholar 

  12. Izquierdo L, Peri L, Garcia-Cruz E, et al. 3D advances in laparoscopic vision. Eur UrologicalRev. 2012;7(2):137–9.

    Google Scholar 

  13. Arezzo A, Kees T, Kunert W, De Gregori M, Buess G. Shadow optic. An endoscope with optimized light. Chir Ital. 2000;52:451–3.

  14. Storz P, Buess GF, Kunert W, et al. 3D HD versus 2d HD: surgical task efficiency in standardised phantom tasks. Surg Endosc. 2012;26:1454–60.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

The authors declare that they have no conflict of interest

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

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

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Correspondence to Giuseppe Currò.

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Currò, G., La Malfa, G., Caizzone, A. et al. Three-Dimensional (3D) Versus Two-Dimensional (2D) Laparoscopic Bariatric Surgery: a Single-Surgeon Prospective Randomized Comparative Study. OBES SURG 25, 2120–2124 (2015). https://doi.org/10.1007/s11695-015-1674-y

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  • DOI: https://doi.org/10.1007/s11695-015-1674-y

Keywords

  • 2D laparoscopy
  • 3D laparoscopy
  • Bariatric surgery