Three-dimensional versus two-dimensional laparoscopy in urology: A randomized study

Abstract

Introduction:Conventional two-dimensional (2D) laparoscopy systems have the drawback of poor depth perception and spatial orientation. Three-dimensional (3D) laparoscopic systems have stereoscopic vision in which depth perception is achieved by different unique images received by each eye. We evaluated 3D laparoscopy in comparison with conventional 2D laparoscopy in urological procedures in a prospective randomized study.Materials and Methods:Over a 19 month study period, 108 patients scheduled to undergo various urological procedures were randomized to either conventional 2D or 3D laparoscopy (2D n = 53; 3D n = 55). A single senior surgeon performed all the surgeries. Parameters such as total operative time, dissection and suturing time, blood loss, hospital stay, complications (Clavien-Dindo), and visual analog scale (VAS) score for pain were assessed. The subjective assessment of the operating surgeon of superiority and inferiority of either technology on parameters defining surgical skills was recorded using a Likert scale.Results:The total operative time (P < 0.0003), blood loss (P < 0.028), dissection, suturing and stenting time (P < 0.0001), and the State-Trait Anxiety Inventory for Adults score (P < 0.0001) was significantly in favor of 3D laparoscopy.Conclusion:Our study showed significant advantages of the 3D system over 2D laparoscopy. These advantages include enhanced operative performance and greater surgeon comfort.

Two-Dimensional Versus Three-Dimensional Laparoscopic Systems in Urology: A Systematic Review and Meta-Analysis

“…Three studies 16 , 24 , 31 compared 2D and 3D laparoscopic systems during the pyeloplasty procedure (53 vs 45 patients, respectively). Of all the parameters reported in these studies, only operative time and EBL were comparable for meta-analysis.…”

Comparative Study of the Influence of Three-Dimensional Versus Two-Dimensional Urological Laparoscopy on Surgeons' Surgical Performance and Ergonomics: A Systematic Review and Meta-Analysis

“…12 The most commonly used 3D imaging systems were the Karl Storz FULL HD 3D System (Karl Storz GmbH & Co. KG, Tüttlingen, Germany) [13][14][15][16][17][18][19][20][21] and the Viking 3D HD Laparoscopic Vision System (Viking Systems, Inc., La Jolla, CA). [22][23][24][25][26][27][28][29][30] Additionally, the Einstein Vision 3D (Schoelly-Fibreoptic GMBH, Germany) was used in some studies. 31,32 Others, such as McDougall et al, conducted their studies with the Endolive Stereo Endoscope (Carl Zeiss, Oberkochen, Germany) and the StereoVu Video Laparoscopen (Welch Allyn Surgical Imaging Systems, Skaneateles Falls, NY) systems.…”

“…The time required to complete the critical steps during adrenalectomy, nephron-sparing nephrectomy, radical and simple nephrectomy, pyeloplasty, and ureterolithotomy was shortened using 3D vision. 13 Furthermore, a reduction in dissection time was reported for simple nephrectomy 23 and pyeloplasty 19,23 when using 3D vision systems. The efficiency score for pyeloplasty and partial nephrectomy was better using 3D imaging compared with conventional 2D technology.…”

What's inside

“…This randomized study included 108 patients in each of the two arms: two-dimensional and 3-D laparoscopy. [ 6 ] The authors evaluated a number of surgical parameters and outcomes and concluded that depth perception allows improvement in operative time and lowers the surgeon's stress.…”