2D versus 3D Laparoscopic Adrenalectomy: A Single-Centre Experience

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Laparoscopic Techniques

Background:

• Laparoscopic adrenalectomy is a standard minimally invasive procedure for adrenal tumors.
• Advancements in laparoscopic technology, such as three-dimensional (3D) visualization, aim to enhance surgical precision and outcomes.
• Comparing the efficacy of 3D versus conventional two-dimensional (2D) systems is crucial for optimizing surgical practice.

Purpose of the Study:

• To compare the operative performance and perioperative outcomes of laparoscopic adrenalectomy using 3D versus 2D systems.
• To evaluate differences in operative time, blood loss, tumor size, complications, and hospital stay between the two visualization techniques.

Main Methods:

• Retrospective observational study including 41 patients undergoing laparoscopic adrenalectomy by a single surgeon.
• Comparison of outcomes between patients operated with 3D (n=22) and 2D (n=19) laparoscopic systems.
• Statistical analysis using independent samples t-test, Mann-Whitney U test, chi-square, or Fisher's exact test (p<0.05 significant).

Main Results:

• The 3D group showed significantly shorter operative time (62.5 vs. 100 min, p<0.001) and lower blood loss (20 vs. 200 mL, p<0.001).
• Patients in the 3D group experienced significantly shorter hospital stays (2 vs. 4 days, p<0.001).
• Tumor size was smaller in the 3D group (p=0.069), and postoperative complication rates were similar between groups.

Conclusions:

• Three-dimensional laparoscopy may enhance operative performance and perioperative outcomes in adrenalectomy compared to 2D laparoscopy.
• The study's retrospective nature and small sample size necessitate cautious interpretation.
• Larger prospective studies are recommended to validate the benefits of 3D laparoscopy in adrenalectomy.