Comparison of 2D 4K vs. 3D HD laparoscopic imaging systems in bariatric surgery: study protocol for a randomized controlled prospective trial

Tibor A Zwimpfer; Nadja Stiegeler; Philip C Müller; Andreas Schötzau; Bernhard Fellmann-Fischer; Viola Heinzelmann-Schwarz; Ralph Peterli; Marko Kraljević

doi:10.1186/s13063-024-07983-4

Comparison of 2D 4K vs. 3D HD laparoscopic imaging systems in bariatric surgery: study protocol for a randomized controlled prospective trial

Trials. 2024 Feb 22;25(1):140. doi: 10.1186/s13063-024-07983-4.

Authors

Tibor A Zwimpfer^#¹, Nadja Stiegeler^#², Philip C Müller³, Andreas Schötzau⁴, Bernhard Fellmann-Fischer⁴, Viola Heinzelmann-Schwarz⁴, Ralph Peterli³, Marko Kraljević³

Affiliations

¹ Department of Obstetrics and Gynecology, University Hospital Basel, Basel, 4056, Switzerland. tibor.zwimpfer@gmx.ch.
² Medical Faculty, University Basel, Basel, 4056, Switzerland.
³ Department of Visceral Surgery, Clarunis - University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, Basel, 4002, Switzerland.
⁴ Department of Obstetrics and Gynecology, University Hospital Basel, Basel, 4056, Switzerland.

^# Contributed equally.

Abstract

Background: Vision is an important and defining element of laparoscopy and significantly affects the outcome of surgery in terms of time, error, and precision. Several new imaging systems have become available for laparoscopic surgery, including three-dimensional (3D) high-definition (HD) and two-dimensional (2D) ultra-high-resolution (4K) monitors. 3D HD systems offer a number of potential benefits to surgeons and patients over traditional 2D systems, including reduced operating time, blood loss, and hospital stay. However, the performance of 3D systems against the new, ultra-high definition 4K systems is barely known and highly controversial. There is a paucity of studies comparing them in clinical settings. The aim of this study is to compare 2D 4K and 3D HD perspectives in gastric bypass surgery.

Methods: Forty-eight patients with an indication for gastric bypass will be randomized to receive laparoscopic gastric bypass surgery using either 2D 4K or 3D HD systems. The operations will be performed by a well-coordinated team of three senior surgeons. The primary outcome is operative time. Secondary outcomes include intraoperative complications, blood loss, operator workload as assessed by the validated Surg-TLX questionnaire, and postoperative complications according to the Clavien-Dindo classification. An interim analysis is planned after enrollment of 12 participants for each group.

Discussion: This prospective, randomized trial is designed to test the hypothesis that the use of a 3D HD system will result in a significant improvement in operative time compared to a 2D 4K system in bariatric surgery. The objective is to provide clinical evidence for new laparoscopic imaging systems and to evaluate potential benefits.

Trial registration: This trial is registered at clinicaltrials.gov under the identifier NCT05895058. Registered 30 May 2023. BASEC2023-D0014 [Registry ID Swissethics, approved 3 May 2023]. SNCTP000005489 [SNCTP study register, last updated 13 July 2023].

Keywords: 2D 4K vision system; 3D HD vision system; Bariatric surgery; Gastric bypass; Laparoscopy; Operating time; Surg-TLX; Workload.

Publication types

Clinical Trial Protocol

MeSH terms

Clinical Competence
Gastric Bypass* / adverse effects
Humans
Imaging, Three-Dimensional / methods
Laparoscopy* / adverse effects
Laparoscopy* / methods
Prospective Studies
Randomized Controlled Trials as Topic
Workload

Associated data

ClinicalTrials.gov/NCT05895058