[Evaluation and future direction of three-dimensional laparoscopy in gastric cancer]

It has been thirty years since the three-dimensional (3D) laparoscopy was put into clinical use. The advantages of 3D laparoscopy are depth perception, high cost-efficacy, tactile feedback, education for basic procedures in laparoscopy and accurate operation. Currently, high-level of evidence for 3D laparoscopy in gastric cancer is still lacking. The advantage of 3D laparoscopy could be maximized in complicated procedures, like hilar lymphadenectomy and totally laparoscopic reconstruction in gastrectomy. In order to acquire optimal depth perception, optimal standing position and stereoacuity check should be emphasized for surgeons in 3D laparoscopic surgery. In light of the limitation of 3D laparoscopy, glass-free 3D laparoscopy and real-time navigation-assisted 3D laparoscopy may be one of the future directions. The value of 3D laparoscopy in obese patients and comparison with robot surgical system are worth further investigating.