Three-dimensional versus two-dimensional laparoscopic right colectomy: a systematic review and meta-analysis

Three-dimensional (3D) vision technology has recently been validated for the improvement of surgical skills in a simulated setting. Clinical studies on specific operations have been published in the field of general, urologic, and gynecologic laparoscopic surgery. We hypothesized that 3D vision laparoscopic right colectomy has better intra and short-term postoperative outcomes than two-dimensional (2D) vision.

The outcomes of this review and meta-analysis were to compare the 3D vision and the 2D vision laparoscopic right colectomy.

A systematic search of the literature was performed on Pubmed, WOS, Google Scholar, and Scopus databases (Prospero reg. nr. 42016047704) for comparative studies between 2D and 3D laparoscopic right colectomy. Primary endpoints were safety issues and secondarily patients' related and surgeons' comfort outcomes. Meta-analyses, when possible, were conducted with a random-effects model.

Two retrospective comparative studies (for a total of 56 patients in the 2D arm and 52 patients for the 3D arm) were selected out of 680 screened records. Methodological quality was fair. Three-dimensional laparoscopic right colectomy has similar safety and secondary outcomes when compared to 2D, with not statistically significant shorter operating times (mean difference 11.81 min). The results are comparable also for anastomosis leakage. The results for other outcomes were not aggregated for heterogeneity.

3D laparoscopic right colectomy shows equivalent patients' outcomes compared to 2D operation, but the scarce clinical data and the potential amelioration of surgeons' skills, especially on difficult intracorporeal tasks like suturing, suggest the publication of further trials.