Three-Dimensional Versus Two-Dimensional Laparoscopic Right Hemicolectomy

Background and Aims: To address the issue whether three dimensional (3D) offers real operative time advantages to the surgical procedure (primary endpoint) and significant reduction of surgeon's physical strain (secondary endpoint), we have retrospectively analyzed two consecutive series of laparoscopic right hemicolectomy (LRH) performed by a single experienced laparoscopic colorectal surgeon with two different imaging systems (two dimensional [2D] and 3D). Patients and Methods: Since January 2014, 25 consecutive patients with right colon cancer underwent 3D LRH and other 25 consecutive ones received a 2D LRH by a single experienced surgeon. After the insertion of the access ports, the surgical procedure has been divided in component tasks and the execution times were compared. Upon completion of each procedure, the consultant surgeon was asked to complete a nonvalidated subjective questionnaire to evaluate quality of depth perception and surgical strain. Results: The execution times for the entire procedure and the single tasks were not significantly different between the 2D and 3D groups, except for the second task "side-to-side ileotransverse anastomosis" (P < .05). The surgeon experienced better depth perception with the 3D system and subjectively reported less strain using the 3D vision system rather than the 2D system, particularly during longer procedures. Conclusions: Three-dimensional imaging seems not to influence the performance time of laparoscopic right colon cancer surgery when the surgeon is experienced in 2D laparoscopy, although the 3D system seems to offer better depth perception and to subjectively determine less physical strain compared to 2D vision. Further comparative studies are necessary to address the issue whether novice surgeons could benefit from a reduced learning curve using 3D vision and to verify with greater numbers if 3D, even with a similar operative time, can reduce perioperative complications.