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Three-Dimensional Versus Two-Dimensional Laparoscopy in Laparoscopic Liver Resection: A Systematic Review and
Kai Siang Chan1, Vishal G Shelat1,2,3
1Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
Summary
Three-dimensional (3D) laparoscopy may reduce overall postoperative morbidity in laparoscopic liver resections (LLR) compared to two-dimensional (2D) LLR. However, the learning curve and surgeon experience may influence these outcomes.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Hepatobiliary Surgery
Background:
- Three-dimensional (3D) laparoscopy offers stereoscopic vision, potentially improving outcomes in laparoscopic liver resections (LLR).
- Limited literature exists comparing 3D and 2D LLR outcomes.
- This study systematically reviews existing evidence to compare 3D and 2D LLR.
Approach:
- A systematic search of PubMed, Embase, Scopus, and Cochrane Library was conducted up to November 2022.
- Included studies compared intraoperative and/or postoperative outcomes of 3D versus 2D LLR.
- Studies focusing solely on 3D preoperative planning were excluded.
Key Points:
- Four studies with 361 patients (159 3D, 202 2D) were analyzed.
- No significant differences were found in operating time, estimated blood loss, reoperation rates, or in-hospital mortality.
- Overall postoperative morbidity was significantly lower in the 3D LLR group (OR 0.56, P=.04).
Conclusions:
- 3D LLR may be associated with reduced overall postoperative morbidity compared to 2D LLR.
- Potential confounding factors include the learning curve and lack of standardized surgeon experience with 3D technology.
- Further research is needed to clarify the impact of the learning curve on 3D LLR outcomes.
