Alberto Arezzo1, Nereo Vettoretto2, Nader K Francis3, Marco Augusto Bonino4, Nathan J Curtis3,5, Daniele Amparore6, Simone Arolfo4, Manuel Barberio7, Luigi Boni8, Ronit Brodie9, Nicole Bouvy10, Elisa Cassinotti8, Thomas Carus11, Enrico Checcucci6, Petra Custers10, Michele Diana7, Marilou Jansen12, Joris Jaspers13, Gadi Marom9, Kota Momose14, Beat P Müller-Stich15, Kyokazu Nakajima14, Felix Nickel15, Silvana Perretta7, Francesco Porpiglia6, Francisco Sánchez-Margallo16, Juan A Sánchez-Margallo16, Marlies Schijven12, Gianfranco Silecchia17, Roberto Passera4, Yoav Mintz9. 1. Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy. alberto.arezzo@unito.it. 2. Montichiari Surgery, ASST Spedali Civili Brescia, Montichiari, Italy. 3. Department of General Surgery, Yeovil District Hospital NHS Foundation Trust, Higher Kingston, Yeovil, UK. 4. Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy. 5. Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK. 6. Division of Urology, ESUT Research Group, San Luigi Gonzaga Hospital, Orbassano, Torino, Italy. 7. IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France. 8. Department of Surgery, Fondazione IRCCS Cà Granda, Policlinico Hospital, University of Milan, Milan, Italy. 9. Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. 10. Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. 11. Department of Surgery, Center for Minimally Invasive Surgery, Asklepios Westklinikum Hamburg, Hamburg, Germany. 12. Department of Surgery, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands. 13. Department of Medical Technology and Clinical Physics, University Medical Centre Utrecht, Utrecht, The Netherlands. 14. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan. 15. General-, Visceral-and Transplant Surgery, University of Heidelberg Hospital, Heidelberg, Germany. 16. Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain. 17. Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy.
Abstract
BACKGROUND: The use of 3D laparoscopic systems is expanding. The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference with the aim of creating evidence-based statements and recommendations for the surgical community. METHODS: Systematic reviews of the PubMed and Embase libraries were performed to identify evidence on potential benefits of 3D on clinical practice and patient outcomes. Statements and recommendations were prepared and unanimously agreed by an international surgical and engineering expert panel which were presented and voted at the EAES annual congress, London, May 2018. RESULTS: 9967 abstracts were screened with 138 articles included. 18 statements and two recommendations were generated and approved. 3D significantly shortened operative time (mean difference 11 min (8% [95% CI 20.29-1.72], I2 96%)). A significant reduction in complications was observed when 3D systems were used (RR 0.75, [95 CI% 0.60-0.94], I2 0%) particularly for cases involving laparoscopic suturing (RR 0.57 [95% CI 0.35-0.90], I2 0%). In 69 box trainer or simulator studies, 64% concluded trainees were significant faster and 62% performed fewer errors when using 3D. CONCLUSION: We recommend the use of 3D vision in laparoscopy to reduce the operative time (grade of recommendation: low). Future robust clinical research is required to specifically investigate the potential benefit of 3D laparoscopy system on complication rates (grade of recommendation: high).
BACKGROUND: The use of 3D laparoscopic systems is expanding. The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference with the aim of creating evidence-based statements and recommendations for the surgical community. METHODS: Systematic reviews of the PubMed and Embase libraries were performed to identify evidence on potential benefits of 3D on clinical practice and patient outcomes. Statements and recommendations were prepared and unanimously agreed by an international surgical and engineering expert panel which were presented and voted at the EAES annual congress, London, May 2018. RESULTS: 9967 abstracts were screened with 138 articles included. 18 statements and two recommendations were generated and approved. 3D significantly shortened operative time (mean difference 11 min (8% [95% CI 20.29-1.72], I2 96%)). A significant reduction in complications was observed when 3D systems were used (RR 0.75, [95 CI% 0.60-0.94], I2 0%) particularly for cases involving laparoscopic suturing (RR 0.57 [95% CI 0.35-0.90], I2 0%). In 69 box trainer or simulator studies, 64% concluded trainees were significant faster and 62% performed fewer errors when using 3D. CONCLUSION: We recommend the use of 3D vision in laparoscopy to reduce the operative time (grade of recommendation: low). Future robust clinical research is required to specifically investigate the potential benefit of 3D laparoscopy system on complication rates (grade of recommendation: high).
Entities:
Keywords:
3D laparoscopy; 3D vision; Consensus; Imaging; Laparoscopic; Three-dimensional
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