Three-dimensional versus two-dimensional laparoscopic myomectomy: A randomized controlled trial

Area of Science:

• Minimally invasive gynecological surgery
• Surgical imaging technologies

Background:

• Laparoscopic myomectomy is a key procedure for symptomatic uterine fibroids.
• Advancements in surgical visualization, such as three-dimensional (3D) imaging, aim to improve surgical precision and outcomes.
• The comparative efficacy of 3D versus conventional two-dimensional (2D) imaging in laparoscopic myomectomy requires rigorous evaluation.

Purpose of the Study:

• To compare the surgical outcomes of three-dimensional (3D) versus two-dimensional (2D) laparoscopic myomectomy.
• To assess differences in operative blood loss, hemoglobin level changes, and operative time between the two imaging modalities.

Main Methods:

• A randomized controlled trial involving 64 patients with symptomatic uterine fibroids.
• Patients were allocated to either a 3D laparoscopic myomectomy group (n=32) or a 2D laparoscopic myomectomy group (n=32).
• Primary outcomes included operative blood loss and change in hemoglobin; operative time was a secondary outcome.

Main Results:

• No significant differences were observed between the 3D and 2D groups regarding operative blood loss (129.5 ± 86.5 mL vs. 140.9 ± 89.8 mL, P=0.412).
• Changes in serum hemoglobin levels were comparable between groups (1.4 ± 1.6 g/dL vs. 1.6 ± 1.6 g/dL, P=0.553).
• Operative time did not differ significantly between the 3D and 2D laparoscopic myomectomy groups (77.4 ± 37.8 min vs. 82.4 ± 35.4 min, P=0.344).

Conclusions:

• The implementation of a 3D imaging system in laparoscopic myomectomy does not offer additional surgical benefits compared to the conventional 2D imaging system.
• Current evidence suggests that 3D visualization does not significantly enhance key surgical outcomes in this specific procedure.
• Further research may explore potential benefits in more complex cases or with different technological advancements.