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3D visualization reduces operating time when compared to high-definition 2D in laparoscopic liver resection: a case-matched study

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Abstract

Objective

To evaluate the effect of three-dimensional (3D) visualization on operative performance during elective laparoscopic liver resection (LLR).

Background

Major limitations of conventional laparoscopy are lack of depth perception and tactile feedback. Introduction of robotic technology, which employs 3D imaging, has removed only one of these technical obstacles. Despite the significant advantages claimed, 3D systems have not been widely accepted.

Methods

In this single institutional study, 20 patients undergoing LLR by high-definition 3D laparoscope between April 2014 and August 2014 were matched to a retrospective control group of patients who underwent LLR by two-dimensional (2D) laparoscope.

Results

The number of patients who underwent major liver resection was 5 (25 %) in the 3D group and 10 (25 %) in the 2D group. There was no significant difference in contralateral wedge resection or combined resections between the 3D and 2D groups. There was no difference in the proportion of patients undergoing previous abdominal surgery (70 vs. 77 %, p = 0.523) or previous hepatectomy (20 vs. 27.5 %, p = 0.75). The operative time was significantly shorter in the 3D group when compared to 2D (225 ± 109 vs. 284 ± 71 min, p = 0.03). There was no significant difference in blood loss in the 3D group when compared to 2D group (204 ± 226 in 3D vs. 252 ± 349 ml in 2D group, p = 0.291). The major complication rates were similar, 5 % (1/20) and 7.5 % (3/40), respectively, (p ≥ 0.99).

Conclusion

3D visualization may reduce the operating time compared to high-definition 2D. Further large studies, preferably prospective randomized control trials are required to confirm this.

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Abbreviations

ASA:

American Society of Anesthesiology

LLR:

Laparoscopic liver resection

LMH:

Laparoscopic major hepatectomy

POD:

Postoperative day

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Disclosures

Vimalraj Velayutham, David Fuks, Takeo Nomi, Yoshikuni Kawaguchi and Brice Gayet have no conflict of interest. Brice Gayet is consultant for Olympus.

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Authors and Affiliations

  1. Department of Digestive Diseases, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France

    Vimalraj Velayutham, David Fuks, Takeo Nomi, Yoshikuni Kawaguchi & Brice Gayet

  2. Université Paris Descartes, Paris, France

    Vimalraj Velayutham, David Fuks, Takeo Nomi, Yoshikuni Kawaguchi & Brice Gayet

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  1. Vimalraj Velayutham
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Correspondence to Vimalraj Velayutham.

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Velayutham, V., Fuks, D., Nomi, T. et al. 3D visualization reduces operating time when compared to high-definition 2D in laparoscopic liver resection: a case-matched study. Surg Endosc 30, 147–153 (2016). https://doi.org/10.1007/s00464-015-4174-1

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