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High-definition resolution three-dimensional imaging systems in laparoscopic radical prostatectomy: randomized
Hidefumi Kinoshita1, Ken Nakagawa, Yukio Usui
1Department Urology and Andrology, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, 573-1010, Japan, kinoshih@hirakata.kmu.ac.jp.
Surgical Endoscopy
|November 2, 2014
Summary
Three-dimensional (3D) imaging in laparoscopic radical prostatectomy (LRP) did not significantly reduce operation times compared to two-dimensional (2D) imaging. However, 3D imaging improved surgical feasibility and reduced surgeon effort without increasing fatigue.
Area of Science:
- Urology
- Surgical Technology
- Medical Imaging
Background:
- Laparoscopic surgery presents challenges in depth perception and 2D to 3D image conversion.
- Three-dimensional (3D) imaging aims to enhance visualization and potentially improve surgical outcomes.
- The clinical benefits of 3D imaging in complex laparoscopic procedures require further investigation.
Purpose of the Study:
- To compare the perioperative outcomes, feasibility, and surgeon fatigue between 3D-high-definition (HD) and 2D-HD imaging during laparoscopic radical prostatectomy (LRP).
- To determine if 3D-HD imaging offers advantages over 2D-HD imaging in LRP.
- To evaluate the impact of imaging modality on the time to perform vesicourethral anastomosis (VUA).
Main Methods:
- A multicenter, open-label, randomized trial involving 122 patients undergoing LRP.
- Patients were assigned to either 2D-HD or 3D-HD imaging groups.
- Primary outcome was the time for vesicourethral anastomosis (VUA); secondary outcomes included operative time, fatigue, and feasibility.
Main Results:
- Vesicourethral anastomosis (VUA) time was not significantly different between the 3D and 2D groups (mean 26.7 min vs. 30.1 min, p=0.11).
- Experienced surgeons and 3D-HD imaging were independent predictors of shorter VUA times.
- Subjective feasibility and satisfaction scores were significantly higher in the 3D group, with no significant difference in fatigue levels.
Conclusions:
- 3D imaging in LRP offers limited advantages in reducing overall operative times compared to 2D systems.
- The 3D imaging system enhances surgical feasibility and reduces surgeon effort during LRP.
- 3D imaging may be beneficial in improving the surgical experience without inducing significant fatigue.
