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3D laparoscopy does not reduce operative duration or errors in day-case laparoscopic cholecystectomy: a randomised
Katie E Schwab1,2,3, Nathan J Curtis4,5, Martin B Whyte6
1Minimal Access Therapy Training Unit, University of Surrey, Daphne Jackson Road, Guildford, UK. katschwab@doctors.org.uk.
Surgical Endoscopy
|July 18, 2019
Summary
Stereoscopic (3D) laparoscopy did not reduce overall operative time or errors in specialist-performed cholecystectomies. However, 3D systems improved efficiency in complex cases and reduced gallbladder perforations.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Clinical Trials
Background:
- Stereoscopic (3D) imaging in laparoscopy has shown promise in trainee and laboratory settings.
- Limited clinical data exists on the impact of 3D systems in specialist-performed procedures.
- Contemporary 3D platforms aim to enhance surgical performance.
Purpose of the Study:
- To evaluate if stereoscopic (3D) laparoscopic systems reduce operative time and intraoperative errors.
- To assess the efficacy of 3D laparoscopy in specialist-performed laparoscopic cholecystectomy (LC).
Main Methods:
- A parallel-arm, randomized controlled trial comparing 2D and 3D passive-polarized laparoscopic systems.
- Eleven experienced consultant surgeons participated, performing day-case laparoscopic cholecystectomies.
- Operative time, subtask duration, and intraoperative errors were assessed using video recording and validated analytical techniques.
Main Results:
- No significant difference in overall operative time between 2D and 3D LC (p=0.148).
- 3D surgery was significantly faster for difficulty grades 3 and 4 cases (p<0.001).
- Overall error counts were similar, but 3D systems showed a significant reduction in gallbladder perforations (p=0.034).
Conclusions:
- 3D laparoscopy did not decrease overall operative time or error frequency in specialist cholecystectomies.
- 3D systems demonstrated benefits in reducing operative time for complex cases and minimizing iatrogenic gallbladder perforations.
- The study provides clinical data on the use of 3D laparoscopy by experienced surgeons.
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