Three-dimensional versus two-dimensional imaging during laparoscopic cholecystectomy: a systematic review and meta-analysis of randomised controlled trials

Davies, Sian; Ghallab, Mohammed; Hajibandeh, Shahab; Hajibandeh, Shahin; Addison, Sarah

doi:10.1007/s00423-020-01909-9

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…These authors showed that both novice and experienced participant times improved with 3D visualization [12]. There have been many studies comparing 2D to 3D laparoscopic vision showing decreased operative time [13,14]; a systemic review noted that the percentage of studies showing a benefit for 3D visualization has increased over time, which may be due to an improvement in the technology [15].…”

Section: Discussionmentioning

confidence: 99%

Study on augmented reality for robotic surgery bedside assistants

et al. 2021

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Robotic surgery bedside assistants play an important role in robotic procedures by performing intra-corporeal tasks while accommodating the physical presence of the robot. We hypothesized that an augmented reality headset enabling 3D intracorporeal vision while facing the surgical field could decrease time and improve accuracy of robotic bedside tasks. Bedside assistants (one physician assistant, one medical student, three surgical trainees, and two attending surgeons) performed validated tasks within a mock abdominal cavity with a surgical robot docked. Tasks were performed with a bedside monitor providing 2D or 3D vision, or an optical see-through head-mounted augmented reality device with 2D or 3D vision. The effect of augmented reality device resolution on performance was also evaluated. For the simplest task of touching a straw, performance was generally high, regardless of mode of visualization. With more complex tasks, including stapling and pulling a ring along a path, 3D augmented reality decreased time and number of errors per task. 3D augmented reality allowed the physician assistant to perform at the level of an attending surgeon using 3D augmented reality (p = 0.08). All participants had improved times for the ring path task with better resolution (lower resolution 23 ± 11 s vs higher resolution 14 ± 4 s, p = 0.002). 3D augmented reality vision with high resolution decreased time and improved accuracy of more complex tasks, enabling a less experienced robotic surgical bedside assistant to function similar to attending surgeons. These data warrant further study with additional complex tasks and bedside assistants at various levels of training.

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Section: Discussionmentioning

confidence: 99%

Study on augmented reality for robotic surgery bedside assistants

et al. 2021

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“…Specifically, a significant or clinically relevant benefit with 3D LC has not been demonstrated in terms of improved patient outcomes 2 . Prior studies have shown similar post‐operative outcomes between 2D and 3D visualization systems in LC and no difference in rates of conversion to an open procedure 3 . However, isolating the impact of the camera system on complication rates is challenging, given the low incidence of serious events during LC 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Anecdotally, 3D camera systems provide the surgeon with enhanced identification of surgical planes and improved control over instrument movements 6 . However, data illustrating improvements have been variable, compounded by inconsistent definitions of the operative errors used to quantify differences 3,7,8 …”

Section: Introductionmentioning

confidence: 99%

“…2 Prior studies have shown similar postoperative outcomes between 2D and 3D visualization systems in LC and no difference in rates of conversion to an open procedure. 3 However, isolating the impact of the camera system on complication rates is challenging, given the low incidence of serious events during LC. 4 For example, major bile duct injury occurs in $0.1-0.3% of cases, and so, identifying the potential impact of the camera system on such events is problematic and would require a prohibitively large data set.…”

Section: Introductionmentioning

confidence: 99%

“…6 However, data illustrating improvements have been variable, compounded by inconsistent definitions of the operative errors used to quantify differences. 3,7,8 Consequently, there is a dearth in the literature about the exact relationship between the type of visualization system and intraoperative efficiency. Additionally, significant disparities may only become apparent in difficult and prolonged cases, where operator fatigue potentially increases error rates.…”

Section: Introductionmentioning

confidence: 99%

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3D visualization systems improve operator efficiency during difficult laparoscopic cholecystectomy: a retrospective blinded review of surgical videos

Patel,

Tranter‐Entwistle,

Sirimanna

et al. 2024

ANZ Journal of Surgery

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Background3D visualization systems in laparoscopic surgery have been proposed to improve manual task handling compared to 2D, however, few studies have compared the intra‐operative efficacy in laparoscopic cholecystectomy (LC). The aim of this study is to determine if there is a benefit in intra‐operative efficiency when using a 3D visualization system in difficult LC compared to traditional 2D visualization systems.MethodsRetrospective analysis of ‘difficult’ LCs (Grades 3 or 4) was completed. The assessor was blinded as all cases were recorded and viewed in 2D only. Variables collected included time to complete steps, missed hook diathermy attempts, failed grasp attempts, missed clip attempts and preparation steps for intra‐operative cholangiogram (IOC). Multiple linear regression was undertaken for time variables, Poisson regression or negative binomial regression was completed for continuous variables.ResultsFifty‐two operative videos of ‘difficult’ LC were reviewed. 3D systems were associated with reduced operative times, although this was not statistically significant (CI: −2.93–14.93, P‐value = 0.183). Dissection of the anterior fold to achieve the critical view of safety was significantly faster by 3.55 min (CI: 1.215–9.206, P‐value = 0.002), and with considerably fewer errors when using 3D systems. Fewer IOC preparation errors were observed with a 3D system compared with a 2D system.Conclusions3D systems appear to enhance operator efficiency, allowing faster completion of critical steps with fewer errors. This pilot study underscores the utility of video annotation for intra‐operative assessment and suggests that, in larger multi‐centre studies, 3D systems may demonstrate superior intra‐operative efficiency over 2D systems during a ‘difficult’ LC.

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