Three-dimensional versus two-dimensional laparoscopy for cholecystectomy in a canine cadaveric study

Vet Surg. 2023 Nov 20. doi: 10.1111/vsu.14046. Online ahead of print.

Abstract

Objective: To compare the effect of three-dimensional (3D) and two-dimensional (2D) laparoscopy on surgical time and intraoperative complications during cholecystectomies in canine cadavers.

Study design: Experimental prospective study.

Animals: Twelve canine cadavers.

Methods: The laparoscopic cholecystectomies were performed in canine cadavers with four cannulas and with either 2D or 3D cameras by a single surgeon. The following surgical times were recorded: time from insertion of laparoscopic instruments to first endoclip placement, time from first endoclip placement to second endoclip placement, time from second endoclip placement to complete gall bladder dissection, and total surgical time. The cystic duct length distal to the first endoclip, intraoperative complications, and the amount of liver attached to the gall bladder were also recorded.

Results: Time from the insertion of the instruments to the application of the first endoclip was shorter for the 3D group than for the 2D group (p = .016). Other surgical times were not different between groups. There was no difference in the cystic duct length distal to the first endoclip, intraoperative complications, or the amount of liver attachment.

Conclusion: Three-dimensional laparoscopy shortened the time from insertion of the laparoscopic instruments to placement of the first endoclip. However, total surgical time was not affected by the type of camera in laparoscopic cholecystectomy.

Clinical significance: Three-dimensional laparoscopy may be beneficial when performing procedures requiring enhanced spatial orientation. However, this technique did not shorten the total surgical time in this cadaveric study. Further studies in a clinical setting are necessary for the optimization of the future use of 3D laparoscopy.