The use of 3D laparoscopic imaging systems in surgery: EAES consensus development conference 2018

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).

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Fig. 1

Reproduced with permission from Moher et al. [117]

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Reproduced with permission from Moher et al. [117]

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Acknowledgements

We would like to acknowledge Nicoletta Colombi for helping us in determining the correct syntax for the search strategy.

Funding

This project was supported and funded by the EAES.

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Correspondence to Alberto Arezzo.

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Nader Francis and Nathan J Curtis received technical support consisting of 3D stacks from Karl Storz Endoscopy UK Ltd as a free research loan for their study “The role of 3D laparoscopic rectal surgery: a randomised controlled trial” (ISRCTN59485808). Alberto Arezzo, Nereo Vettoretto, Marco Augusto Bonino, Daniele Amparore, Simone Arolfo, Manuel Barberio, Luigi Boni, Ronit Brodie, Nicole Bouvy, Elisa Cassinotti, Thomas Carus, Enrico Checcucci, Petra Custers, Michele Diana, Marilou Jansen, Joris Jaspers, Gadi Marom, Kota Momose, Beat P Müller-Stich, Kyokazu Nakajima, Felix Nickel, Silvana Perretta, Francesco Porpiglia, Francisco Sánchez-Margallo, Juan A Sánchez-Margallo, Marlies Schijven, Gianfranco Silecchia, Roberto Passera and Yoav Mintz have no conflict of interest or financial ties to disclose.

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Arezzo, A., Vettoretto, N., Francis, N.K. et al. The use of 3D laparoscopic imaging systems in surgery: EAES consensus development conference 2018. Surg Endosc 33, 3251–3274 (2019). https://doi.org/10.1007/s00464-018-06612-x

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Keywords

  • 3D laparoscopy
  • 3D vision
  • Three-dimensional
  • Imaging
  • Laparoscopic
  • Consensus