Two-dimensional versus three-dimensional laparoscopy in surgical efficacy: a systematic review and meta-analysis

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Comparative Effectiveness Research

Background:

• Laparoscopy is a key surgical technique.
• Comparative efficacy of 2D vs. 3D laparoscopy is uncertain.
• Systematic review and meta-analysis needed to clarify differences.

Purpose of the Study:

• To systematically review and meta-analyze trials comparing 2D and 3D laparoscopy.
• To determine the comparative efficacy of 3D versus 2D laparoscopy.
• To identify potential confounding factors through subgroup analysis.

Main Methods:

• Comprehensive database screening (PubMed, Web of Science, EMBASE, Cochrane).
• Inclusion of clinical trials comparing 2D and 3D laparoscopy.
• Methodological appraisal using Newcastle-Ottawa and Revised Jadad's Scales.
• Sensitivity and publication bias analyses (Begg's, Egger's tests).

Main Results:

• 21 high-quality trials included; 3D laparoscopy superior in surgical time, blood loss, complications, and hospital stay.
• Comparable results for secondary endpoints like drainage, lymph node retrieval, and costs.
• Sensitivity analysis confirmed outcome stability.
• Publication bias detected but results remained stable after adjustment.

Conclusions:

• Three-dimensional laparoscopy demonstrates superior surgical efficacy over 2D laparoscopy.
• 3D laparoscopy is a preferred surgical option for improved patient outcomes.
• Evidence supports the adoption of 3D laparoscopy in surgical practice.