Why laparoscopists may opt for three-dimensional view: a summary of the full HTA report on 3D versus 2D laparoscopy by S.I.C.E. (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie)

Abstract

BackgroundThree-dimensional view in laparoscopic general, gynaecologic and urologic surgery is an efficient, safe and sustainable innovation. The present paper is an extract taken from a full health technology assessment report on three-dimensional vision technology compared with standard two-dimensional laparoscopic systems.MethodsA health technology assessment approach was implemented in order to investigate all the economic, social, ethical and organisational implications related to the adoption of the innovative three-dimensional view. With the support of a multi-disciplinary team, composed of eight experts working in Italian hospitals and Universities, qualitative and quantitative data were collected, by means of literature evidence, validated questionnaire and self-reported interviews, applying a final MCDA quantitative approach, and considering the dimensions resulting from the EUnetHTA Core Model.ResultsFrom systematic search of literature, we retrieved the following studies: 9 on general surgery, 35 on gynaecology and urology, both concerning clinical setting. Considering simulated setting we included: 8 studies regarding pitfalls and drawbacks, 44 on teaching, 12 on surgeons’ confidence and comfort and 34 on surgeons’ performances. Three-dimensional laparoscopy was shown to have advantages for both the patients and the surgeons, and is confirmed to be a safe, efficacious and sustainable vision technology.ConclusionsThe objective of the present paper, under the patronage of Italian Society of Endoscopic Surgery, was achieved in that there has now been produced a scientific report, based on a HTA approach, that may be placed in the hands of surgeons and used to support the decision-making process of the health providers.Electronic supplementary materialThe online version of this article (10.1007/s00464-017-6006-y) contains supplementary material, which is available to authorized users.

2D versus 3D laparoscopic total mesorectal excision: a developmental multicentre randomised controlled trial

“…Although the need for a complete specimen is unaltered, variation in perineal and low rectal technique could have directly influenced histopathology results. The health economics of 3D laparoscopy have not been sufficiently reported to date although a recent health technology assessment suggested the additional cost per patient for 3D systems in general surgery could be as low as €1.67 [15]. Our data suggest no meaningful secondary impact on healthcare resources could be expected.…”

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

“… 37 In contrast, Vettoretto and colleagues reported that adaption of the 3D system saves money for hospitals based on reduction in the operating time. 38 However, other investigators failed to find any significant difference between 2D and 3D laparoscopic surgeries concerning total surgical expenses. 27 , 28 On the other hand, discomfort, nausea, dizziness, and eye strains are among the reported limitations associated with the old generation of the 3D laparoscopic system.…”

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

“…49 Although the purchase of a 3D imaging system can be up to 66% more expensive than a conventional 2D laparoscopic system, 50 eventually 3D imaging systems have shown a considerable benefit in terms of blood loss, operative time, and hospital stay, resulting in a reduction of the costs associated with the intervention. 50,51 In addition, improved depth perception, surgical precision and hand/eye coordination with 3D laparoscopic systems allow for reduced surgery time, thus reducing cost, exposure time to anesthesia and morbidity. 51,52 This means better patient safety and therefore shorter hospitalization time and lower costs related to postoperative hospital stay.…”