Three-dimensional (3D) visualization provides better outcome than two-dimensional (2D) visualization in single-port laparoscopic distal gastrectomy: a propensity-matched analysis

Purpose There are currently no reports on the application of three-dimensional (3D) vision to single-incision laparoscopic surgery. This study compared 3D vision to the previous two-dimensional (2D) system in single-incision laparoscopic distal gastrectomy (SIDG). Methods Medical charts of 179 gastric cancer patients who underwent SIDG from February 2014 to December 2017 were retrospectively reviewed. Patients were grouped into either a 2D group or 3D group depending on the type of camera that was used. All operations were performed using a flexible camera (Olympus, Japan). Operative data and postoperative outcome were analyzed. Results There were 90 patients in the 2D group and 89 patients in the 3D group. No differences were found in terms of the age, body mass index, staging, and other demographics of the patients. Operative time was significantly faster in the 3D group (115.6 +/- 34.0 vs. 129.4 +/- 38.5 min,p = 0.012), and estimated blood loss (EBL) was less in the 3D group (20.7 +/- 30.0 vs. 35.1 +/- 56.0 ml,p = 0.034). Patients in the 3D group were able to start a small fluid diet earlier (2.5, range 1-6 vs. 3.0, range 2-8 postoperative days,p = 0.006) and were discharged faster (5.4, range 3-12 vs. 6.2, range 4-24 postoperative days,p = 0.024). There was no statistical difference between early and late complications. Conclusion The use of the 3D camera shortened operative time with possible clinical benefits for patients undergoing SIDG.