Abstract
Background
To address the issue whether three-dimensional (3D) offers real operative time advantages to the laparoscopic surgical procedure, we have designed a single-surgeon prospective randomized comparison of 3D versus two-dimensional (2D) imaging during two different bariatric procedures.
Methods
Forty morbidly obese patients were randomized on the day of surgery by a random computer-generated allocation list to receive either a 3D high-definition (HD) display or 2D HD imaging system laparoscopic bariatric procedure by a single experienced surgeon. Forty operations were performed with either a 3D HD display or 2D HD imaging system. After the insertion of the access ports, both surgical procedures were divided in component tasks, and the execution times were compared.
Results
The execution times for the entire procedure and the single tasks were not significantly different between the 2D and 3D groups during sleeve gastrectomy. The execution times for the entire procedure and the single tasks, except for the first one, were significantly different between the 2D and 3D groups during mini-gastric bypass (p < 0.05). The surgeon experienced better depth perception with the 3D system and subjectively reported less strain using 3D vision system rather than the 2D system particularly during longer procedure.
Conclusions
3D imaging seems to decrease the performance time of more difficult bariatric procedures, which involve surgical tasks as suturing and intestinal measurement. Further comparative studies are necessary to address the issue if novice surgeons could benefit from reduced learning curve requested with 3D vision and to verify with greater numbers if 3D imaging can reduce complications.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sinha R, Sundaram M, Raje S, et al. 3D laparoscopic: technique and initial experience in 451 cases. GynecolSurg. 2013;10:123–8.
Buchwald M, Oien MD. Metabolic/bariatric surgery worldwide 2011. ObesSurg. 2013;23:427–36.
Van Bergen P, Kunert W, Bessell J, et al. Comparative study of 2D and 3D vision systems for minimally invasive surgery. SurgEndosc. 1998;12:948–54.
Hanna GB, Shimi SM, Cuschieri A. Randomised study of influence of two-dimensional versus three-dimensional imaging on performance of laparoscopic cholecystectomy. Lancet. 1998;351:248–51.
Melissas J. IFSO guidelines for safety, quality and excellence in bariatric surgery. Obes Surg. 2008;18:497–500.
Lee WJ, Lin YH. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg. 2014;24:1749–56.
Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. SurgEndosc. 2006;20:859–63.
de Tavares de MenezesEttinger JEM, dos Santos Filho PV, Azaro E, et al. Prevention of rhabdomyolysis in bariatric surgery. Obesity Surg. 2005;15:874–9.
Qaseem A, Snow V, Fittermann N, et al. Risk assessment for and strategies to reduce perioperative pulmonary complications for patients undergoing noncardiothoracic surgery: a guideline from the American College of Physician. Ann Intern Med. 2006;144:575–80.
Narani KK. Deep vein thrombosis and pulmonary embolism—prevention, management, and anaesthetics consideration. Indian J Anaesth. 2010;54(1):8–17.
Diwakar S, Mittu JM, Prasanna KR. 3D laparoscopy—help or hype; initial experience of a tertiary health centre. J Clin Diag Res. 2014;8(7):NC01–3.
Izquierdo L, Peri L, Garcia-Cruz E, et al. 3D advances in laparoscopic vision. Eur UrologicalRev. 2012;7(2):137–9.
Arezzo A, Kees T, Kunert W, De Gregori M, Buess G. Shadow optic. An endoscope with optimized light. Chir Ital. 2000;52:451–3.
Storz P, Buess GF, Kunert W, et al. 3D HD versus 2d HD: surgical task efficiency in standardised phantom tasks. Surg Endosc. 2012;26:1454–60.
Conflict of Interest
The authors declare that they have no conflict of interest
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Currò, G., La Malfa, G., Caizzone, A. et al. Three-Dimensional (3D) Versus Two-Dimensional (2D) Laparoscopic Bariatric Surgery: a Single-Surgeon Prospective Randomized Comparative Study. OBES SURG 25, 2120–2124 (2015). https://doi.org/10.1007/s11695-015-1674-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-015-1674-y