Three-dimensional laparoscopic Roux-en-Y gastric bypass with totally hand-sewn anastomoses for morbid obesity. A single center experience

Abstract

To assess the impact of three-dimensional (3D) vision use on operative time (OT) in laparoscopic Roux-en-Y gastric bypass (LRYGB) with hand-sewn anastomoses. Methods: We analyzed a prospectively collected database of patients who underwent LRYGB. We included all patients operated on with either 2D or 3D vision. Demographics and clinical characteristics, operative time, hospital stay and 30-day postoperative complications were collected for all patients and analyzed. Results: During the study time, out of 143 patients who underwent LRYGB for morbid obesity, 111 were considered eligible. Seventy-eight patients were operated with 2D vision and 33 patients with 3D vision. Demographics and clinical characteristics were not different among groups. Mean OT was 203±51 and 167±32 minutes in the 2D and 3D groups respectively (p<0.001). Multivariate analyses showed that increasing age and BMI were independently related to prolonged OT, while 3D vision (OR 6.675, 95% CI 2.380-24.752, p<0.001) was strongly associated with shorter OT. Conclusions: The use of 3D vision in LRYGB significantly reduced the OT, though intra-and postoperative complication rates and the length of hospital stay were not affected. Despite its limitations, our study supports the value of 3D vision laparoscopy in bariatric surgery.

Three-dimensional Versus Two-dimensional Laparoscopic Bariatric Surgery: A Systematic Review and Meta-analysis

“…In other studies [ 2 , 12 ], no statistically significant values were observed for global complications, except for that by Padin et al, who analyzed the occurrence of complications based on the surgeon's experience at the beginning of the study. In this study, complications were recorded in the group of patients who were operated on by novice surgeons.…”

“…Another study was excluded because it was not conducted in English. Finally, only six studies [ 2 , 10 – 14 ] were included in the present meta-analysis based on the aforementioned inclusion criteria. These were all single-center studies including four prospective [ 10 – 13 ] and two retrospective [ 2 , 14 ] studies.…”

“…Finally, only six studies [ 2 , 10 – 14 ] were included in the present meta-analysis based on the aforementioned inclusion criteria. These were all single-center studies including four prospective [ 10 – 13 ] and two retrospective [ 2 , 14 ] studies. A total of 629 patients who underwent 3D or 2D laparoscopic bariatric surgery were included in the meta-analysis.…”

“…2 ). Concerning the GB group [ 2 , 10 , 11 , 13 , 14 ], the pooled SMD was 1.19 (95% CI 2.22-0.15). High heterogeneity was observed (I2 = 86%, P < 0.01) (Fig.…”

“…The development of laparoscopic vision platforms has promoted technological innovations in minimally invasive surgeries [ 1 ]. Most surgeons routinely use two-dimensional (2D) laparoscopy, which provides unfavorable images in terms of depth perception and hand-eye coordination [ 2 ]. Three-dimensional (3D) laparoscopy has introduced a new perspective for minimally invasive surgical procedures in the field of general surgery.…”