Surgeon Preference and Clinical Outcome of 3D Vision Compared to 2D Vision in Laparoscopic Surgery: Systematic Review and Meta-Analysis of Randomized Trials

Medientyp: E-Artikel
Titel: Surgeon Preference and Clinical Outcome of 3D Vision Compared to 2D Vision in Laparoscopic Surgery: Systematic Review and Meta-Analysis of Randomized Trials
Beteiligte: Amiri, Rawin; Zwart, Maurice J. W.; Jones, Leia R.; Abu Hilal, Mohammad; Beerlage, Harrie P.; van Berge Henegouwen, Mark I.; Lameris, Wytze W.; Bemelman, Willem A.; Besselink, Marc G.
Erschienen: Ovid Technologies (Wolters Kluwer Health), 2024
Erschienen in: Annals of Surgery Open, 5 (2024) 2, Seite e415
Sprache: Englisch
DOI: 10.1097/as9.0000000000000415
ISSN: 2691-3593
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Beschreibung: <jats:sec> <jats:title>Objective:</jats:title> <jats:p>To assess the added value of 3-dimensional (3D) vision, including high definition (HD) technology, in laparoscopic surgery in terms of surgeon preference and clinical outcome.</jats:p> </jats:sec> <jats:sec> <jats:title>Background:</jats:title> <jats:p>The use of 3D vision in laparoscopic surgery has been suggested to improve surgical performance. However, the added value of 3D vision remains unclear as a systematic review of randomized controlled trials (RCTs) comparing 3D vision including HD technology in laparoscopic surgery is currently lacking.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines with a literature search up to May 2023 using PubMed and Embase (PROSPERO, CRD42021290426). We included RCTs comparing 3D versus 2-dimensional (2D) vision in laparoscopic surgery. The primary outcome was operative time. Meta-analyses were performed using the random effects model to estimate the pooled effect size expressed in standard mean difference (SMD) with corresponding 95% confidence intervals (CIs). The level of evidence and quality was assessed according to the Cochrane risk of bias tool.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>Overall, 25 RCTs with 3003 patients were included. Operative time was reduced by 3D vision (−8.0%; SMD, −0.22; 95% CI, −0.37 to −0.06; <jats:italic toggle="yes">P</jats:italic> = 0.007; n = 3003; 24 studies; <jats:italic toggle="yes">I</jats:italic> <jats:sup>2</jats:sup> = 75%) compared to 2D vision. This benefit was mostly seen in bariatric surgery (−16.3%; 95% CI, −1.28 to −0.21; <jats:italic toggle="yes">P</jats:italic> = 0.006; 2 studies; n = 58; <jats:italic toggle="yes">I</jats:italic> <jats:sup>2</jats:sup> = 0%) and general surgery (−6.7%; 95% CI, −0.34 to −0.01; <jats:italic toggle="yes">P</jats:italic> = 0.036; 9 studies; n = 1056; <jats:italic toggle="yes">I</jats:italic> <jats:sup>2</jats:sup> = 41%). Blood loss was nonsignificantly reduced by 3D vision (SMD, −0.33; 95% CI, −0.68 to 0.017; <jats:italic toggle="yes">P</jats:italic> = 0.060; n = 1830; <jats:italic toggle="yes">I</jats:italic> <jats:sup>2</jats:sup> = 92%). No differences in the rates of morbidity (14.9% vs 13.5%, <jats:italic toggle="yes">P</jats:italic> = 0.644), mortality (0% vs 0%), conversion (0.8% vs 0.9%, <jats:italic toggle="yes">P</jats:italic> = 0.898), and hospital stay (9.6 vs 10.5 days, <jats:italic toggle="yes">P</jats:italic> = 0.078) were found between 3D and 2D vision. In 15 RCTs that reported on surgeon preference, 13 (87%) reported that the majority of surgeons favored 3D vision.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Across 25 RCTs, this systematic review and meta-analysis demonstrated shorter operative time with 3D vision in laparoscopic surgery, without differences in other outcomes. The majority of surgeons participating in the RCTs reported in favor of 3D vision.</jats:p> </jats:sec>
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