Two-dimensional (2D) versus three-dimensional (3D) laparoscopy for vaginal cuff closure by surgeons-in-training: a randomized controlled trial

Ajao, Mobolaji O.; Larsen, Claus; Manoucheri, E.; Goggins, Emily R.; Rask, Maja Thode; Cox, Mary; Mushinski, A.A.; Gu, Xiangmei; Cohen, Sarah L.; Rudnicki, Martin; Einarsson, Jon I.

doi:10.1007/s00464-019-06886-9

Cited by 14 publications

(9 citation statements)

References 18 publications

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“…Indeed, both in our study and in the study by Ajao et al (2020) 3D did not provide an advantage over monocular vision even by restricting the population of operators to trainees and to complex surgical procedures (vaginal cuff closure and total hysterectomy).…”

Section: Discussioncontrasting

confidence: 48%

4K versus 3D total laparoscopic hysterectomy by resident in training: a prospective randomised trial

Restaino¹,

Vargiu²,

Rosati³

et al. 2021

Facts Views Vis ObGyn

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Background: The introduction of ultra-high-definition laparoscopic cameras (4K), by providing stronger monocular depth perception, could challenge the existing 3D technology. There are few available studies on this topic, especially in gynaecological setting. Objectives: Prospective, single institution, randomised clinical trial (NCT04209036). Materials and Methods: The two laparoscopes utilised were the 0°ULTRA Telescopes with 4K technology and the 0°3D-HD by Olympus. The surgeons were all trainees and in their last year of residency and who had obtained the certificate of first or second level of the Gynaecological Endoscopic Surgical Education and Assessment program - GESEA program. Twenty-nine patients with benign uterine pathology were enrolled. Main outcome measures: To compare if the use three-dimensional (3D) versus ultra-high-definition laparoscopic vision system (4K) for total laparoscopic hysterectomy performed by trainees was associated with a shorter operative time. Results: The 3D vision system did not prove to be superior to the 4K vision system. Operators reported significantly more vision-related side effects when using 3D than 4K. Completing the GESEA training program was the only factor with a positive and statistically significant impact on the overall time of the procedure, especially when greater dexterity and tissue handling were required. Conclusions: Neither technology used proved superior to the other, although operators showed a preference for 4K over 3D due to the lower number of visual side effects. Attendance at courses on laparoscopic simulators and training programs allowed trainees to demonstrate excellent surgical skills.

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Section: Discussioncontrasting

confidence: 48%

4K versus 3D total laparoscopic hysterectomy by resident in training: a prospective randomised trial

Restaino¹,

Vargiu²,

Rosati³

et al. 2021

Facts Views Vis ObGyn

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“…In this regard, previous studies suggest that 3D may be more beneficial for less experienced trainees [5,19,20]. However, at least one study in the educational setting evaluating laparoscopic vaginal cuff closure during total laparoscopic hysterectomy by surgeons-in-training could not show any significant difference between 2D and 3D vision in the time needed for completion of this surgical step, and also the surgeons' subjective rating of the "ease of cuff closure" did not differ between groups [8]. Taken together, further studies evaluating more complex tasks and surgeries, objective outcome measures, and differentiating the results based on the participants' surgical experience are needed.…”

Section: Discussionmentioning

confidence: 84%

“…In the educational setting with simpler surgical tasks, no significant difference between the two visualization modalities was found; for example, a randomized controlled study evaluating the laparoscopic closure of the vaginal cuff during total laparoscopic hysterectomy by surgeons-in-training could not show any significant difference between 2D and 3D systems in the time needed for completion of this surgical step, and also the surgeons' subjective rating of the "ease of cuff closure" did not differ between groups [8].…”

Section: Introductionmentioning

confidence: 99%

Basic Laparoscopic Skills Training Is Equally Effective Using 2D Compared to 3D Visualization: A Randomized Controlled Trial

Montanari

Schwameis

Veit‐Rubin

et al. 2020

JCM

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Reduced depth perception due to two-dimensional (2D) visualization of a three-dimensional (3D) space represents a main challenge in acquiring basic laparoscopic skills (BLS); 3D visualization might increase training efficiency. This study aimed to assess whether BLS training on a standard box trainer using 2D is at least equally effective compared to 3D. Medical students were randomized to training of Fundamentals of Laparoscopic Surgery (FLS) tasks using either 2D or 3D for four weeks. Baseline and post-training tests were performed using the assigned visualization modality. Data of 31 participants were analyzed (n = 16 2D, n = 15 3D). Baseline test scores did not differ significantly between groups; only at the peg transfer task and total scores, the 3D group performed better than the 2D group. All scores improved significantly in both groups, with post training scores not differing significantly between groups. Non-inferiority of 2D compared to 3D was demonstrated for total score improvement and improvement in all individual FLS tasks except for suturing with extracorporeal knot tying. Post training test performance did not change significantly when changing to the unfamiliar modality. In conclusion, BLS training using standard 2D is at least equally effective as with 3D, without significant disadvantages when changing to the other modality.

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“…The same is true in other elds, such as gynecology [34] , pediatric surgery [35] , and urology [36] . However, there are also studies that did not nd these differences and established that 3D laparoscopic surgery does not represent advantages over 2D laparoscopic surgery [37,38] .…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Surgery in 3D Improves Results and Surgeon Convenience in Sleeve Gastrectomy for Morbid Obesity

Martínez-Ubieto¹,

Barranco-Dominguez²,

Tardós-Ascaso

et al. 2021

Preprint

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Background. Advanced laparoscopic procedures are still challenging. One critical issue is the lack of stereoscopic vision. The aim of this surgical study is to evaluate whether 3D vision offers any advantages for surgical performance over 2D vision during sleeve gastrectomy for morbid obesity using a laparoscopic system that allows changing between 2D and 3D optics.Method. A total of 78 patients were analyzed, with 37 in the 2D group and 41 in the 3D group. Performance time, hospital stay, complications and early outcomes were collected. To assess the quality of the 2D and 3D techniques, visual analog scales (VASs) from 0 to 10 were designed, and image quality, depth of field, precision in performing tasks and general ergonomics were measured.Results. According to the vision system used, the mean duration of surgery was 85 ± 16.8 minutes for patients operated on with the 2D system and 69 ± 16.9 minutes for those operated on with the 3D system. There were no significant differences between the overall percentages of complications according to the type of vision used. However, postoperative complications were more severe in the 2D laparoscopy group. The average length of stay was shorter for patients in the 3D group. Regarding the differences perceived by the surgeon, the depth of field and the precision of tasks were better in the 3D vision group.Conclusion. The 3D system provided greater depth perception and precision in more complex tasks, enabling safer surgery. This led to a reduction in the operative time and hospital stay. Moreover, the severity of complications was less.

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Two-dimensional (2D) versus three-dimensional (3D) laparoscopy for vaginal cuff closure by surgeons-in-training: a randomized controlled trial

Cited by 14 publications

References 18 publications

4K versus 3D total laparoscopic hysterectomy by resident in training: a prospective randomised trial

4K versus 3D total laparoscopic hysterectomy by resident in training: a prospective randomised trial

Basic Laparoscopic Skills Training Is Equally Effective Using 2D Compared to 3D Visualization: A Randomized Controlled Trial

Laparoscopic Surgery in 3D Improves Results and Surgeon Convenience in Sleeve Gastrectomy for Morbid Obesity

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