Three-dimensional Laparoscopy (3D-LC) Versus Minilaparotomy (MC) in Cholecystectomy: A Prospective Randomized Study

Area of Science:

• Minimally Invasive Surgery
• Surgical Innovation
• Gastrointestinal Surgery

Background:

• Three-dimensional laparoscopy (3D-Lap) is an emerging surgical technology.
• Its application in cholecystectomy (3D-LC) is infrequent.
• No prior prospective studies have compared 3D-LC with minilaparotomy (MC) for cholecystectomy.

Purpose of the Study:

• To prospectively evaluate the advantages and disadvantages of 3D-LC versus MC in cholecystectomy.
• To compare postoperative pain levels between the two surgical techniques.

Main Methods:

• A prospective randomized clinical study was conducted.
• 200 patients with symptomatic cholelithiasis were assigned to either 3D-LC (n=112) or MC (n=88).
• Postoperative pain was assessed using the Numeric Rating Scale (NRS) and the number of analgesic doses (NAD).

Main Results:

• Postoperative pain scores were similar in the initial hours, with 3D-LC showing a lower NRS score at one hour.
• Significantly less pain was reported 24 hours postoperatively in the 3D-LC group (NRS at rest: 1.2 vs 2.2; pain with movement: 2.9 vs 3.6).
• Statistical significance was observed for NRS at rest (p<0.001) and pain with movement (p=0.05).

Conclusions:

• Patients undergoing 3D-LC for cholecystectomy experienced significantly reduced pain 24 hours postoperatively compared to MC.
• While patient pain perception is multifactorial, the study indicates that both 3D-LC and MC are safe and effective for cholecystectomy.
• 3D-LC may offer an advantage in long-term postoperative pain management.