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Pham NH, Phan KS, Bui CLK, Nguyen VQA, Le LV, Ngo TL, Nguyen KT, Truong VC, Tran NK. Three-Dimensional Laparoscopic Nephrectomy for Benign Nonfunctioning Kidneys: A Single-Center Initial Experience. Cureus 2024; 16:e60352. [PMID: 38756712 PMCID: PMC11096772 DOI: 10.7759/cureus.60352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND There are several types of benign renal diseases, such as urological stones, ureteropelvic junction obstruction, renal vascular disease, and inflammation, which are responsible for nonfunctioning kidneys. Laparoscopic nephrectomy (LN) is the gold standard for treating nonfunctioning kidneys with complications. This study presents the results of our initial experiences with 3D laparoscopic nephrectomy (3D-LN) for benign, nonfunctioning kidneys. METHODS From July 2021 to July 2023, 40 consecutive patients who underwent 3D transperitoneal laparoscopic nephrectomy were retrospectively evaluated at the Department of Urology and Department of General Surgery, Hue Central Hospital, Hue, Vietnam. Patient demographics, intraoperative and early postoperative results, postoperative recovery, complications, and three-month follow-up results were recorded. RESULTS The mean age was 58.35 ± 14.9 years. There were 13 (32.5%) male and 27 (67.5%) female patients. Flank pain was the main reason for hospitalization in 33 cases (82.5%); the common cause of a nonfunctioning kidney was urological stones (62.5%). Twenty-three out of 40 patients underwent a left nephrectomy. The average operative time was 92.57 ± 28.69 minutes. A statistically significant difference in surgery time was found between the group with no adhesion and the group with mild adhesion, as well as between the first 19 patients and the last 18 patients (p <0.05). The mean blood loss was 51.62 ± 24.35 ml. Three cases were converted to open surgery due to severe adhesions. The postoperative complications rate was 8.1%. The average length of the postoperative hospital stay was 7.89 ± 3.59 days. CONCLUSIONS Three-dimensional laparoscopic nephrectomy is a safe and effective method that increases depth perception and spatial orientation for surgeons and can compensate for the remaining shortcomings of traditional 2D systems.
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Affiliation(s)
| | - Khac Sang Phan
- Department of Surgery, Hoan My Hospital, Binh Phuoc, VNM
| | - Cong Le Kha Bui
- Deparment of Urology, Hue Central Hospital, Hue, VNM
- Deparment of General Surgery, Hue Central Hospital, Hue, VNM
| | | | - Luong Vinh Le
- Department of General Surgery, Hue Central Hospital, Hue, VNM
| | - Thanh Liem Ngo
- Department of General Surgery, Hue Central Hospital, Hue, VNM
| | | | | | - Ngoc Khanh Tran
- Department of General Surgery, Hue Central Hospital, Hue, VNM
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Xu Y, Huang J, Fan X, Wang Z, Lou J, Liu X, Weng G. Clinical experience of bench surgery combined with autotransplantation after three-dimensional laparoscopic nephrectomy for the treatment of highly complex renal tumor. World J Surg Oncol 2023; 21:373. [PMID: 38031058 PMCID: PMC10687882 DOI: 10.1186/s12957-023-03246-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE To assess the feasibility and safety of three-dimensional (3D) laparoscopic nephrectomy in combination with bench surgery and autotransplantation for treating highly complex renal tumors. MATERIALS AND METHODS The clinical data of six patients with highly complex renal cell carcinoma were collected. All patients underwent 3D laparoscopic nephrectomy in combination with bench surgery and autotransplantation by the same surgeons, two of them had previously undergone laparoscopic partial nephrectomy for contralateral renal cancer. RESULTS The total operative time was 366 ± 65 min, the warm ischemia time (WIT) was 1.3 ± 0.4 min, and the cold ischemia time was 121 ± 26 min. While one patient received a diluted autologous blood transfusion, the intraoperative blood loss was 217 ± 194 ml. No increase in the serum creatinine (SCr) level was observed at postoperative day 30 compared with the preoperative time, and none of the patients received dialysis either during the hospital stay or to date. Although one patient underwent nephrectomy due to tumor recurrence in the transplanted kidney, the others reported no tumor recurrence or distant metastases on imaging to date. CONCLUSION 3D laparoscopic nephrectomy, when combined with bench surgery and autotransplantation, can become a feasible option for treating highly complex renal cell carcinoma cases when expecting to preserve renal function maximally.
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Affiliation(s)
- Yangkai Xu
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, 315100, Zhejiang, China
| | - Jiawen Huang
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, 315100, Zhejiang, China
| | - Xiaodong Fan
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, 315100, Zhejiang, China
| | - Zhichao Wang
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, 315100, Zhejiang, China
| | - Jiangyong Lou
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, 315100, Zhejiang, China
| | - Xiaoming Liu
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, 315100, Zhejiang, China
| | - Guobin Weng
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo, 315100, Zhejiang, China.
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Ahmad MA, Weiler Y, Joyeux L, Eixarch E, Vercauteren T, Ourselin S, Deprest J, Vander Poorten E. 3D vs. 2D simulated fetoscopy for spina bifida repair: a quantitative motion analysis. Sci Rep 2023; 13:20951. [PMID: 38016964 PMCID: PMC10684542 DOI: 10.1038/s41598-023-47531-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 11/14/2023] [Indexed: 11/30/2023] Open
Abstract
3D imaging technology is becoming more prominent every day. However, more validation is needed to understand the actual benefit of 3D versus conventional 2D vision. This work quantitatively investigates whether experts benefit from 3D vision during minimally invasive fetoscopic spina bifida (fSB) repair. A superiority study was designed involving one expert team ([Formula: see text] procedures prior) who performed six 2D and six 3D fSB repair simulations in a high-fidelity animal training model, using 3-port access. The 6D motion of the instruments was recorded. Among the motion metrics are total path length, smoothness, maximum speed, the modified Spectral Arc Length (SPARC), and Log Dimensionless Jerk (LDLJ). The primary clinical outcome is operation time (power 90%, 5% significance) using Sealed Envelope Ltd. 2012. Secondary clinical outcomes are water tightness of the repair, CO[Formula: see text] insufflation volume, and OSATS score. Findings show that total path length and LDLJ are considerably different. Operation time during 3D vision was found to be significantly shorter compared to 2D vision ([Formula: see text] vs. [Formula: see text] min; p [Formula: see text] 0.026). These results suggest enhanced performance with 3D vision during interrupted suturing in fetoscopic SBA repair. To confirm these results, a larger-scale follow-up study involving multiple experts and novice surgeons is recommended.
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Affiliation(s)
- Mirza Awais Ahmad
- Department of Mechanical Engineering Sciences, Catholic University of Leuven, 3000, Leuven, Belgium.
- Obstetrics and Gynaecology, University Hospital of Leuven, 3000, Leuven, Belgium.
| | - Yolan Weiler
- Department of Mechanical Engineering Sciences, Catholic University of Leuven, 3000, Leuven, Belgium
| | - Luc Joyeux
- Obstetrics and Gynaecology, University Hospital of Leuven, 3000, Leuven, Belgium
| | - Elisenda Eixarch
- BCNatal Fetal Medicine Research Center, Hospital Clinic, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain
| | - Tom Vercauteren
- Department of Imaging and Biomedical Engineering, Kings College, London, WC2R 2LS, UK
| | - Sebastien Ourselin
- Department of Imaging and Biomedical Engineering, Kings College, London, WC2R 2LS, UK
| | - Jan Deprest
- Obstetrics and Gynaecology, University Hospital of Leuven, 3000, Leuven, Belgium
| | - Emmanuel Vander Poorten
- Department of Mechanical Engineering Sciences, Catholic University of Leuven, 3000, Leuven, Belgium
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Wahba R, Urbanski A, Datta RR, Kleinert R, Bruno L, Zervakis A, Thomas MN. Operating room time savings in Germany- and UK-based hospitals with 3D- VS. 2D-imaging technology in laparoscopic surgery: Meta analysis and budget impact model - Health economic evaluation. Int J Surg 2022; 102:106643. [PMID: 35490950 DOI: 10.1016/j.ijsu.2022.106643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/16/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022]
Abstract
AIMS Opportunity cost (OC) analysis is key when evaluating surgical techniques. Operating room (OR) time is one potential source of OC in laparoscopic surgery. This study quantifies differences in OR time between 3D- and 2D-imaging technology in laparoscopic surgery, translates these into OC and models the economic impact in real-world hospitals. METHODS First a systematically performed literature review and meta-analysis were conducted. Then, methods to translate OR time savings into OC were theorised and a budget impact model was created. After that, the potential time savings of real-world hospital case mixes were extrapolated. Finally, the opportunity costs of not using 3D-imaging in laparoscopic surgery were evaluated. RESULTS Average OR time saving per laparoscopic procedure was -19.4 min (-24.3; -14.5) (-14%) in favour of 3D. The Budget Impact Model demonstrated an economic impact of using 3D-laparoscopy instead of 2D laparoscopy, ranging from £183,045-£866,316 in the British and 73,049€-437,829€ in German hospitals, modelling a mixture of cost savings and performing additional procedures (earning additional revenue). CONCLUSION The OC analysis revealed significant economic benefits of introducing 3D-imaging technology in laparoscopic surgery, on the basis that average procedure time is reduced. Utilising the saved OR time to perform additional procedures was the biggest driver of OC. Hospital case mix and procedure volume indicated the magnitude of the OC.
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Affiliation(s)
- R Wahba
- Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University of Cologne, University Hospital Cologne, Germany.
| | - A Urbanski
- Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University of Cologne, University Hospital Cologne, Germany.
| | - R R Datta
- Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University of Cologne, University Hospital Cologne, Germany.
| | - R Kleinert
- Department of General and Visceral Surgery, Protestant Hospital of Bethel Foundation, University Hospital OWL, University of Bielefeld, Bielefeld, Germany.
| | - L Bruno
- Olympus Europe SE & Co. KG aA, Germany.
| | | | - M N Thomas
- Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University of Cologne, University Hospital Cologne, Germany.
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Tsukamoto S, Kuchiba A, Moritani K, Shida D, Katayama H, Yorikane E, Kanemitsu Y. Laparoscopic surgery using 8 K ultra-high-definition technology: Outcomes of a phase II study. Asian J Endosc Surg 2022; 15:7-14. [PMID: 33881224 DOI: 10.1111/ases.12943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/25/2021] [Accepted: 04/10/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Currently, laparoscopic surgery generally relies on 2 K high-definition image quality. The National Cancer Center Hospital, Olympus Corporation, and NHK Engineering System Inc. recently developed a new laparoscopic system with an 8 K ultra-high-definition (UHD) camera that provides images with a high-resolution, wide color range, high frame rate, and high dynamic range. This study aimed to investigate the effectiveness and safety of a new laparoscopic system which uses an 8 K UHD camera system (8K UHD system). METHODS This phase II study enrolled 23 patients with colon or rectosigmoid cancer who were indicated for radical resection with laparoscopic colectomy using the 8 K UHD system. The primary endpoint was the proportion of patients with ≥30 mL of intraoperative blood loss. RESULTS Of the 23 patients, 22 completed laparoscopic surgery with the 8 K UHD system. One patient was converted to the 2 K high-definition laparoscopic system due to technical difficulties with the 8 K UHD system during surgery. The median amount of intraoperative blood loss was 14 mL (range, 2-71 mL), and number of patients with intraoperative blood loss ≥30 mL was four (17.4%). None of the patients had >100 mL of intraoperative blood loss. No intraoperative complications were noted, and four (17.4%) patients developed postoperative complications. Pathological complete resection was achieved in all patients, and no conversion to open surgery was required. CONCLUSIONS Laparoscopic surgery using the 8 K UHD system appears to be both safe and effective. However, further refinements may be necessary to improve usability.
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Affiliation(s)
- Shunsuke Tsukamoto
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Aya Kuchiba
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan
| | - Konosuke Moritani
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Dai Shida
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Katayama
- Research Management Section, Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Eiko Yorikane
- Research Management Section, Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
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Balsa IM, Giuffrida MA, Mayhew PD. A randomized controlled trial of three-dimensional versus two-dimensional imaging system on duration of surgery and mental workload for laparoscopic gastropexies in dogs. Vet Surg 2021; 50:944-953. [PMID: 33864647 DOI: 10.1111/vsu.13637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 03/01/2021] [Accepted: 04/04/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To evaluate the effect of three-dimensional (3D) laparoscopy compared to two-dimensional (2D) laparoscopy when evaluating duration of surgery for canine intracorporeally sutured gastropexy. STUDY DESIGN Randomized controlled clinical trial. ANIMALS Thirty client-owned dogs. METHODS Dogs were randomized into 2D or 3D groups and underwent a three-port laparoscopic intracorporeally sutured incisional gastropexy with barbed suture. Procedures were performed by a single board-certified surgeon. Duration of surgery was recorded and workload was assessed immediately after surgery using the NASA Task Load Index (TLX). RESULTS Median duration of surgery was 3 min shorter for 3D versus 2D (95%CI -10 to 13; p = .51). Surgical component durations, total and component TLX scores, and intraoperative complications also did not differ between groups. In a subgroup analysis excluding the first eight cases due to presumption of a learning curve with suturing technique, total TLX score (p = .004) and all component scores were lower for 3D as compared to 2D laparoscopy, although duration of surgery did not differ (p = .20). CONCLUSION The use of 3D laparoscopy was not associated with shorter duration of surgery when compared to 2D laparoscopy. CLINICAL SIGNIFICANCE 3D laparoscopy requires further investigation in veterinary medicine to determine its utility in decreasing surgical duration, surgical complications or surgeon mental or physical workload.
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Affiliation(s)
- Ingrid M Balsa
- Department of Surgical and Radiological Sciences, University of California-Davis, School of Veterinary Medicine, Davis, California, USA
| | - Michelle A Giuffrida
- Department of Surgical and Radiological Sciences, University of California-Davis, School of Veterinary Medicine, Davis, California, USA
| | - Philipp D Mayhew
- Department of Surgical and Radiological Sciences, University of California-Davis, School of Veterinary Medicine, Davis, California, USA
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Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics. J Clin Med 2021; 10:jcm10091812. [PMID: 33919290 PMCID: PMC8122613 DOI: 10.3390/jcm10091812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Introduction: The advent of robotic surgery led to the assumption that laparoscopic surgery would be replaced entirely. However, the high costs of robotic surgery limit its availability. The aim of the current study was to assess the feasibility of the 3D laparoscopic approach for the most complex urological procedures. (2) Materials and methods: We included in the current study all patients who had undergone complex 3D laparoscopic procedures in our department since January 2017, including radical nephrectomy (LRN) using a dual combined approach (19 patients), radical nephroureterectomy (LRNU) with bladder cuff excision (13 patients), and radical cystectomy (LRC) with intracorporeal urinary diversion (ICUD) (21 patients). (3) Results: The mean operative time was 345/230/478 min, the complications rate was 26%/30.76%/23.8% and positive surgical margins were encountered in 3/1/1 patients for the combined approach of LRN/LRNU/LRC with ICUD, respectively. A single patient was converted to open surgery during LRN due to extension of the vena cava thrombus above the hepatic veins. After LRC, sepsis was the most common complication and 8 patients were readmitted at a mean of 15.5 days after discharge. (4) Conclusions: In the era of robotic surgery, laparoscopy remains a plausible alternative for most complex oncological cases.
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Rodríguez-Hermosa JI, Ranea A, Delisau O, Planellas-Giné P, Cornejo L, Pujadas M, Codony C, Gironès J, Codina-Cazador A. Three-dimensional (3D) system versus two-dimensional (2D) system for laparoscopic resection of adrenal tumors: a case-control study. Langenbecks Arch Surg 2020; 405:1163-1173. [PMID: 32909079 DOI: 10.1007/s00423-020-01950-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Laparoscopy is the standard technique for resecting adrenal tumors worldwide. The main drawbacks of conventional 2D laparoscopy are limited depth perception and tactile feedback. Currently available high-quality 3D laparoscopy systems might improve surgical outcomes for adrenalectomy. We compare the safety and efficacy of 3D versus 2D laparoscopy in the treatment of adrenal tumors. METHODS This case-control study analyzed prospectively collected data from patients with benign or malignant adrenal tumors treated laparoscopically at a single academic medical center between April 2003 and March 2020. We collected demographic, diagnostic, preoperative, and operative variables, and used multiple linear and logistic regression to analyze differences in various short-term outcomes between the two approaches while adjusting for potential confounders. RESULTS We included 150 patients: 128 with benign tumors and 22 with malignant tumors; 95 treated with 3D laparoscopy (case group); and 55 with 2D laparoscopy (control group). After adjustment for patient, surgical, and tumor characteristics, a 2D vision was associated with a longer operative time (β = 0.26, p = 0.002) and greater blood loss (β = 0.20, p = 0.047). There was no significant difference in rates of conversion to open surgery (odds ratio [OR] = 1.47 (95% CI 0.90-22.31); p = 0.549) or complications (3.6% vs. 2.1%; p = 0.624). CONCLUSIONS With experienced surgeons, laparoscopic adrenalectomy was safer and more feasible with the 3D system than with the 2D system, resulting in less operative blood loss and shorter operative time with no differences in rates of conversion to open surgery or postoperative complications. For adrenal tumors, 3D laparoscopy offers advantages over 2D laparoscopy.
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Affiliation(s)
- José Ignacio Rodríguez-Hermosa
- Endocrine Surgery Unit, Dr. Josep Trueta University Hospital, Girona, Spain. .,Department of Surgery, Dr. Josep Trueta University Hospital, Girona, Spain. .,Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta University Hospital, Girona, Spain. .,Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain.
| | - Alejandro Ranea
- Endocrine Surgery Unit, Dr. Josep Trueta University Hospital, Girona, Spain.,Department of Surgery, Dr. Josep Trueta University Hospital, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta University Hospital, Girona, Spain
| | - Olga Delisau
- Department of Surgery, Dr. Josep Trueta University Hospital, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta University Hospital, Girona, Spain
| | - Pere Planellas-Giné
- Department of Surgery, Dr. Josep Trueta University Hospital, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta University Hospital, Girona, Spain.,Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
| | - Lídia Cornejo
- Department of Surgery, Dr. Josep Trueta University Hospital, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta University Hospital, Girona, Spain
| | - Marcel Pujadas
- Department of Surgery, Dr. Josep Trueta University Hospital, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta University Hospital, Girona, Spain
| | - Clara Codony
- Department of Surgery, Dr. Josep Trueta University Hospital, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta University Hospital, Girona, Spain
| | - Jordi Gironès
- Endocrine Surgery Unit, Dr. Josep Trueta University Hospital, Girona, Spain.,Department of Surgery, Dr. Josep Trueta University Hospital, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta University Hospital, Girona, Spain.,Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
| | - Antoni Codina-Cazador
- Department of Surgery, Dr. Josep Trueta University Hospital, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta University Hospital, Girona, Spain.,Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
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Sánchez-Margallo FM, Durán Rey D, Serrano Pascual Á, Mayol Martínez JA, Sánchez-Margallo JA. Comparative Study of the Influence of Three-Dimensional Versus Two-Dimensional Urological Laparoscopy on Surgeons' Surgical Performance and Ergonomics: A Systematic Review and Meta-Analysis. J Endourol 2020; 35:123-137. [PMID: 32799686 DOI: 10.1089/end.2020.0284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective: The objective of this study is to compare the use of three-dimensional (3D) vision systems with traditional two-dimensional systems in laparoscopic urological surgery, analyzing the benefits, limitations, and impact of introducing this medical technology with regard to surgical performance and the surgeon's ergonomics. Methods: A systematic review with a structured bibliographic search was conducted in the electronic libraries (PubMed and EMBASE) until August 2019 and with no language restrictions. Studies on 3D visualization technology in laparoscopic urologic surgery, randomized controlled trials, and observational comparative studies were included. Relevant data were extracted and analyzed. Results: A total of 25 articles were obtained, of which 4 were clinical studies with patients, 2 studies were carried out in experimental animal models, and the remaining 19 were conducted in simulated environments. Regarding the European training program in basic laparoscopic urological skills, the results showed no significant differences in execution time using either imaging system. Three-dimensional vision led to a significant reduction in surgery time in pyeloplasty and radical nephrectomy. In addition, there was a reported decrease in blood loss in adrenalectomy, nephron-sparing nephrectomy, radical nephrectomy, simple nephrectomy, and pyeloplasty using 3D vision. Regarding ergonomics, the studies generally described no differences in side effects (headache, nausea, eye strain) when comparing the two types of visualization systems. Surgeons reported reduced workloads and stress with 3D vision than with traditional laparoscopy. Conclusions: Three-dimensional laparoscopic systems essentially advance surgical performance in less-experienced laparoscopic surgeons. Three-dimensional laparoscopy leads to improvements in surgery time, which is important for specific surgical procedures involving intracorporeal ligatures and sutures. The results achieved on the surgeons' ergonomics showed better depth perception and decreased stress and workloads during 3D vision with no differences in potential side effects.
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Affiliation(s)
| | - David Durán Rey
- Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
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10
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Zhuansun D, Jiao C, Meng X, Xiao J, He Y, Feng J. A Study of Three-Dimensional Versus Two-Dimensional Laparoscopic Surgery in Resection of Congenital Choledochal Cyst of Children and Jejunum Roux-en-Y Anastomosis. J Laparoendosc Adv Surg Tech A 2020; 30:344-349. [PMID: 31928494 DOI: 10.1089/lap.2019.0497] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Didi Zhuansun
- Department of Pediatric Surgery, Tongji Medical College, Huazhong University of Science and Technology, Tongji Hospital, Wuhan, China
| | - Chunlei Jiao
- Department of Pediatric Surgery, Tongji Medical College, Huazhong University of Science and Technology, Tongji Hospital, Wuhan, China
| | - Xinyao Meng
- Department of Pediatric Surgery, Tongji Medical College, Huazhong University of Science and Technology, Tongji Hospital, Wuhan, China
| | - Jun Xiao
- Department of Pediatric Surgery, Tongji Medical College, Huazhong University of Science and Technology, Tongji Hospital, Wuhan, China
| | - Ying He
- Department of Pediatric Surgery, Tongji Medical College, Huazhong University of Science and Technology, Tongji Hospital, Wuhan, China
| | - Jiexiong Feng
- Department of Pediatric Surgery, Tongji Medical College, Huazhong University of Science and Technology, Tongji Hospital, Wuhan, China
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Rysmakhanov M, Yelemessov A, Mussin N, Sultangereyev Y, Kaliyev A, Tezcaner T, Yıldırım S. Pure 3-Dimensional Laparoscopic Living-Donor Nephrectomy: First Case In Kazakhstan. EXP CLIN TRANSPLANT 2020; 18:68-69. [PMID: 32008499 DOI: 10.6002/ect.tond-tdtd2019.p12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The available scientific literature has described the tangible benefits of operations using new 3-dimensional laparoscopic systems. The purpose of this report was to describe the first experience of pure 3-dimensional laparoscopic living-donor nephrectomy for transplant in the Republic of Kazakhstan. A living-donor kidney transplant was performed in a 21-year-old male patient with the father as the donor. The operation was performed with general anesthesia using a 3-dimensional endo-videoscopic stance with flexible camera (Olympus, Tokyo, Japan). The time of warm ischemia was 130 seconds, and the total operation time was 280 minutes. The postoperative period proceeded smoothly, without any complication. The patient was discharged on day 3 after transplant with normal levels of creatinine and urea. The recipient's surgery was typical, and no complications or difficulties in perfor-ming anastomosis were encountered. With further accumulation of experience, 3-dimensional laparoscopic nephrectomy from living donors could become a new criterion standard.
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Abstract
Pyeloplasty is one of the most common urological reconstructive interventions. Since the presentation of the first open pyeloplasty by Anderson and Hynes in 1949, the management of ureteropelvic junction obstruction has dramatically developed. The most immense progress was made in the 1990s with the introduction of laparoscopy. A multitude of new minimal surgical techniques have been introduced since then. In the last few years, the innovations were based on refinement of already-existing techniques and technology. With this aim, single-port surgery, three-dimensional vision for laparoscopy, robotic technology, and alternative techniques for creating the anastomosis-like fibrin glue have been introduced. This unsystematic review is timely, and the scientific interest is to present and discuss some of the latest advances in surgical techniques and different approaches for the intra- and post-operative management in pyeloplasty. To the best of our knowledge, this is the only review looking at the recent advances in urological surgical techniques for pyeloplasty during the last few years with a focus on new technology and surgical techniques.
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Affiliation(s)
- Mikolaj Mendrek
- Departement of Urology, University Hospital Aachen, Aachen, 52074, Germany
| | | | - Christian Bach
- Departement of Urology, University Hospital Aachen, Aachen, 52074, Germany
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