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Clinical Use of Third-Generation 3D Imaging Systems in Endoscopic Surgery—a Systematic Review

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Abstract

Purpose

Translational research allowed us to hypothesize that endoscopic surgery performed with new generation 3D systems could improve surgeons’ performance, reducing the learning curve, and the perceived workload. However, there is currently a lack of evidence in randomized clinical trials considering advantages for the surgeon and the patient of using the new 3D systems. This systematic review of literature aims to understand what are the differences when performing an endoscopic surgery with new 3D or 2D systems when it comes to intra-operative, post-operative and surgeons perspective outcomes, and at the same time, understand what were the difficulties encountered when performing research about as different imaging systems for surgeons.

Methods

A systematic review of literature was conducted through an online search in databases MEDLINE ©/PubMed © to identify articles published in English, from 1st January 2014 to 31st May 2019, that compared clinical results of 2D and 3D third-generation video-assisted surgery.

Results

A total of 30 articles were included in the qualitative analyses. Of the 30 articles analyzed, 13 were articles in which patients were randomly selected, of which 7 were considered to be at “Low” risk of bias. From the 7 articles, 2 demonstrated an association between lower blood loss and 3D systems. In this selection of low risk randomized articles, no differences were observed in any of the studies when it comes to conversion to open surgery, intra-operative complications, morbidity, length of stay, and oncological outcomes.

Conclusion

In conclusion, this systematic review presents the current knowledge on clinical use of 3D systems for endoscopic surgery. Significant scientific evidence puts 3D technology with advantages in surgeon performance, learning curve, and fatigue.

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Data Availability

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Funding

This study received no funding.

Author information

Authors and Affiliations

  1. Department of General Surgery, Luz Saúde, Porto, Portugal

    Jaime Vilaça

  2. Hospital da Horta EPE, Azores, Portugal

    José Moreira de Azevedo

  3. Centro Hospitalar Vila Nova de Gaia/Espinho, Porto, Portugal

    Hugo Cardoso Louro

  4. Paediatric Surgery, Hospital de Braga, Braga, Portugal

    Jorge Correia Pinto

  5. Department of General Surgery, School of Medicine, ICVS/3B’s, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal

    Pedro Leão

Authors
  1. Jaime Vilaça
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  2. José Moreira de Azevedo
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  3. Hugo Cardoso Louro
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  4. Jorge Correia Pinto
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  5. Pedro Leão
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Contributions

All the authors contributed to the design of this study, acquisition, and analysis of data. All the authors participated in revising it critically for intellectual content and for final version to be published.

Corresponding author

Correspondence to José Moreira de Azevedo.

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

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This article is part of the Topical Collection on Surgery

Appendix

Appendix

Table 1 Complexity grading system
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Table 2 Study general characteristics and type of imaging used
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Table 3 Intra-operative and post-operative results for articles with low risk of bias
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Table 4 Intra-operative results. MGBp–mini gastric bypass, SG–gastric sleeve
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Table 5 Post-operative factors. *Pentafecta, depth perception (DP), hand-eye (HE), image quality (IQ), operative strain (OS), subjective (Sub), questionnaire (Qst), simulation sickness questionnaire (SSQ), critical flicker fusion (CFF), state-trait anxiety inventory for adults short version score (STAI), Likert scale (LS), lymph nodes (LN)
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Table 6 Risk of bias concerning operative time
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Vilaça, J., de Azevedo, J.M., Louro, H.C. et al. Clinical Use of Third-Generation 3D Imaging Systems in Endoscopic Surgery—a Systematic Review. SN Compr. Clin. Med. 3, 879–896 (2021). https://doi.org/10.1007/s42399-021-00774-x

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