THE NEW GOLD STANDARD IN LAPAROSCOPIC IMAGING: 3D VS 4K LAPAROSCOPIC NEPHRECTOMY- A SINGLE CENTERED RANDOMIZED CONTROLLED TRIAL

Authors

  • Nauman Sadiq Kiani Tabba Kidney Institute
  • Sherjeel Saulat Qazi Tabba Kidney Institute
  • Jahanzeb Sheikh Tabba Kidney Institute Post Graduate, Training & Research Center
  • Awais Ayub Tabba Kidney Institute
  • Hamza Ashraf Tabba Kidney Institute
  • Syed Saeed Uddin Qadri Tabba Kidney Institute
  • Mansoor Ejaz Tabba Kidney Institute

DOI:

https://doi.org/10.55519/JAMC-04-9611

Keywords:

3D imaging, 4K imaging, nephrectomy, operative time

Abstract

Background: Thanks to progressive technology and modern innovations, laparoscopic procedures, being minimally invasive, have now supervened upon most open surgical procedures. Laparoscopic procedures have proven advantages over open procedures. The study was designed to compare the outcomes of laparoscopic nephrectomy between 3D and 4K camera resolutions. Methods: This randomized control trial carried out at Tabba Kidney institute, Karachi, Pakistan from July 2020 to April 2021, to our knowledge was the first of its kind comparative study in Pakistan and internationally. All patients diagnosed to have symptomatic non-functioning kidney on the basis of both renal scintigraphy and CT- KUB were divided through blocked randomization in to two different camera resolution groups, i.e., 3D vs 4K and outcomes in terms of operative time, haemoglobin fall, post procedure complications and in patient stay were recorded. Results: It was observed that the 3D group had a significantly shorter mean total operative time 172.1±36.9 vs 272.5±14.1 respectively (p<0.005). A significant difference was also observed in mean operative time for task 2 was 53.1±21.1 & 101±30.9 mins (p<0.005), and for task 3 was 67.18±18.3 & 112.5±37 mins (p=0.005) for 3D and 4K groups respectively. The mean haemoglobin drops in 3D and 4K groups was 0.51±1.6 & 0.73±1.1 respectively (p=0.7). Moreover, the mean hospital stay was 2.5±0.6 for 3D group & 2.7±0.9 for 4K group (p-value 0.8). Post-operative wound infection was observed in one patient in each group. No case had to be converted to surgery by an open approach. Conclusion: We concluded that despite being the latest technological advancement with a greater zooming capability, when used for performing laparoscopic nephrectomy, 4K imaging system couldn’t show any superiority over 3D imaging system, in different operative tasks and in terms of total operative time.

Author Biographies

Sherjeel Saulat Qazi, Tabba Kidney Institute

Institute: Tabba Kidney Institute Post Graduate, Training & Research Center Department: Department of Urology Designation: Director Surgeries & Head of Urology Department

Jahanzeb Sheikh, Tabba Kidney Institute Post Graduate, Training & Research Center

Institute: Tabba Kidney Institute Post Graduate, Training & Research Center Department: Department of Urology Designation: Lecturer Urology

Awais Ayub, Tabba Kidney Institute

Institute: Tabba Kidney Institute Post Graduate, Training & Research Center Department: Department of Urology Designation: Resident Urology

Hamza Ashraf, Tabba Kidney Institute

Institute: Tabba Kidney Institute Post Graduate, Training & Research Center Department: Department of Urology Designation: Resident Urology

Syed Saeed Uddin Qadri, Tabba Kidney Institute

Institute: Tabba Kidney Institute Post Graduate, Training & Research Center Department: Department of Urology Designation: Consultant Urologist

Mansoor Ejaz, Tabba Kidney Institute

Institute: Tabba Kidney Institute Post Graduate, Training & Research Center Department: Department of Urology Designation: Resident Urology

References

Al-Kandari A, Ganpule AP, Azhar RA, Gill IS, editors. Difficult conditions in laparoscopic urologic surgery. Springer; 2018.

Hanna GB, Shimi SM, Cuschieri A. Randomised study of influence of two-dimensional versus three-dimensional imaging on performance of laparoscopic cholecystectomy. Lancet 1998;351(9098):248–51.

Yazawa H, Takiguchi K, Imaizumi K, Wada M, Ito F. Surgical outcomes of total laparoscopic hysterectomy with 2-dimensional versus 3-dimensional laparoscopic surgical systems. Fukushima J Med Sci 2018;64(1):38–45. Tang FJ, Qi L, Jiang HC, Tong SY, Li Y. Comparison of the clinical effectiveness of 3D and 2D imaging systems for laparoscopic radical cystectomy with pelvic lymph node dissection. J Int Med Res 2016;44(3):613–9.

Kunert W, Storz P, Kirschniak A. For 3D laparoscopy: a step toward advanced surgical navigation: how to get maximum benefit from 3D vision. Surg Endosc 2013;27(2):696–9.

Chan AC, Chung SC, Yim AP, Lau JY, Ng EK, Li AK. Comparison of two-dimensional vs three-dimensional camera systems in laparoscopic surgery. Surg Endosc 1997;11(5):438–40.

Storz P, Buess GF, Kunert W, Kirschniak A. 3D HD versus 2D HD: surgical task efficiency in standardised phantom tasks. Surg Endosc 2012;26(5):1454–60.

Wagner OJ, Hagen M, Kurmann A, Horgan S, Candinas D, Vorburger SA. Three-dimensional vision enhances task performance independently of the surgical method. Surg Endosc 2012;26(10):2961–8.

Serrano OK, Bangdiwala AS, Vock DM, Berglund D, Dunn TB, Finger EB, et al. Defining the tipping point in surgical performance for laparoscopic donor nephrectomy among transplant surgery fellows: A risk‐adjusted cumulative summation learning curve analysis. Am J Transplant 2017;17(7):1868–78.

Wahba R, Datta RR, Hedergott A, Bußhoff J, Bruns T, Kleinert R, et al. 3D vs. 4K Display System-Influence of “State-of-the-art”-Display Technique On Surgical Performance (IDOSP-Study) in minimally invasive surgery: protocol for a randomized cross-over trial. Trials 2019;20(1):1–8.

Bilgen K, Üstün M, Karakahya M, Isik S, Sengül S, Çetinkünar S, et al. Comparison of 3D imaging and 2D imaging for performance time of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 2013;23(2):180–3.

Cicione A, Autorino R, Breda A, De Sio M, Damiano R, Fusco F, et al. Three-dimensional vs standard laparoscopy: comparative assessment using a validated program for laparoscopic urologic skills. Urology 2013;82(6):1444–50.

Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BW, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2015;8:CD003677.

Ridgeway B, Falcone T. Innovations in minimally invasive hysterectomy. Clin Obstet Gynecol 2014;57(1):83–94.

Gurusamy KS, Sahay S, Davidson BR. Three dimensional versus two-dimensional imaging for laparoscopic cholecystectomy. Cochrane Database Syst Rev 2011;1:CD006882.

Bilgen K, Üstün M, Karakahya M, Isik S, Sengül S, Çetinkünar S, et al. Comparison of 3D imaging and 2D imaging for performance time of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 2013;23(2):180–3.

Dunstan M, Smith R, Schwab K, Scala A, Gatenby P, Whyte M, et al. Is 3D faster and safer than 4K laparoscopic cholecystectomy? A randomised-controlled trial. Surg Endosc 2019;18:1–7.

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Published

2022-09-27