Three-dimensional laparoscopy in urology: Initial experience after 100 cases

Abstract

To evaluate the efficacy of three-dimensional (3D) laparoscopy in urological procedures in a cohort study compared to two-dimensional (2D) laparoscopy. From October 2016 to August 2017, 100 patients underwent various urological procedures with 3D laparoscopy performed by a single experienced surgeon at the University Medical Centre of Ho Chi Minh City. The surgeon's subjective assessment of image quality, depth perception, ease of intra-corporeal suturing and knotting was recorded. The State-Trait Anxiety Inventory for Adults (STAI-6) short version was used to quantify aspects of stress experienced during each operative procedure. A subgroup of 73 complicated 3D laparoscopic procedures (nephron sparing nephrectomy, nephrectomy, adrenalectomy, pyeloplasty and ureterolithotomy) was compared to the same clinical parameter group of 74 two-dimensional laparoscopic procedures, performed by the same surgeon in the year before to define the differencesin operative time, blood loss and time taken for critical surgical steps during the procedures. Mean time of operation was 112.8min±14.5 (range 45-210min). Mean estimated blood loss was 54.7mL±8.2 (range 20-100mL). The surgeon's subjective assessment of image quality, depth perception, operative strain, ease of intra-corporeal suturing, and knotting, and hand-eye coordination was considered as good in 100% of cases. Mean score of STAI-6 was 11.6±2.17 (range 10-22). Subgroup data analysis was all statistically better for 3D compared to 2D. The use of 3D systems in laparoscopic urologic procedures resulted in better image quality and better surgeon performance with lower stress.