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Three-dimensional versus two-dimensional imaging during laparoscopic cholecystectomy: a systematic review and meta-analysis of randomised controlled trials

  • Systematic Reviews and Meta-analyses
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the comparative outcomes of three-dimensional (3D) versus two-dimensional (2D) imaging during laparoscopic cholecystectomy.

Methods

We conducted a systematic search of electronic information sources and bibliographic reference lists and applied a combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators and limits. Procedure time, Calot’s triangle dissection time, gallbladder removal time, gallbladder perforation, intraoperative bleeding, postoperative complications, conversion to open and intraoperative errors were the evaluated outcome parameters.

Results

We identified 6 randomised controlled trials (RCT) reporting a total of 577 patients who underwent laparoscopic cholecystectomy using 3D (n = 282) or 2D (n = 295) imaging. The 3D imaging was associated with significantly shorter procedure time (MD − 4.23, 95% CI − 8.14 to − 0.32, p = 0.03), Calot’s triangle dissection time (MD − 4.19, 95% CI − 6.52 to − 1.86, p = 0.0004) and significantly lower risk of gallbladder perforation (RR 0.50, 95% CI 0.28–0.88, p = 0.02) compared to the 2D approach. No significant difference was found in gallbladder removal time (MD − 0.79, 95% CI − 2.24 to 0.66, p = 0.28), intraoperative bleeding (RR 1.14, 95% CI 0.68–1.90, p = 0.61), postoperative complications (RD − 0.01, 95% CI − 0.06 to 0.05, p = 0.85), conversion to open (RD 0.00, 95% CI − 0.02 to 0.03, p = 0.70) or intraoperative errors (RR 0.96, 95% CI 0.79–1.17, p = 0.70) between the two groups.

Conclusions

Although our findings suggest that the use of 3D imaging during laparoscopic cholecystectomy may be associated with significantly shorter procedure time, Calot’s triangle dissection time and gallbladder injury compared to the 2D imaging, the differences seem to be clinically insignificant. Moreover, both approaches carry s similar risk of postoperative morbidities. The impact of the surgeon’s level of experience and difficulty of the procedure on the outcomes of each imaging modality remains unknown.

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References

  1. National Institute for Health and Care Excellence. (2014) Costing statement: gallstone disease – implementing the NICE guideline on gallstone disease (CG188). 2014

  2. Gadacz T, Talamini M (1991) Traditional versus laparoscopic cholecystectomy. Am J Surg 161(3):336–338

    Article  CAS  Google Scholar 

  3. Byrn JC, Schluender S, Divino CM, Conrad J, Gurland B, Shlasko E, Szold A (2007) Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci robot system. Am J Surg 193(4):519–522

    Article  Google Scholar 

  4. Gurusamy KS, Sahay S, Davidson BR (2011) Three dimensional versus two dimensional imaging for laparoscopic cholecystectomy. Cochrane database of systematic reviews, issue 1. Art. No.: CD006882. DOI: https://doi.org/10.1002/14651858.CD006882.pub2

  5. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 339:b2700

    Article  Google Scholar 

  6. Higgins JP, Altman DG, editors Chapter 8 (2018) Assessing risk of bias in included studies. In: Higgins JP, Green S, editors. Cochrane handbook for systematic reviews of interventions. Version 5.0.1[updated September 2008]. Available at: http://hiv.cochrane.org/sites/hiv. cochrane.org/files/uploads/Ch08_Bias.pdf

  7. Hanna GB, Shimi SM, Cuschieri A (1998) Randomised study of influence of two-dimensional versus three-dimensional imaging on performance of laparoscopic cholecystectomy. Lancet. 351(9098):248–251

    Article  CAS  Google Scholar 

  8. Bilgen K, Ustun M, Karakahya M et al (2013) Comparison of 3D imaging and 2D imaging for performance time of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 23:180–183

    Article  Google Scholar 

  9. Curro G, La Malfa G, Lazzara S (2015) Three-dimensional versus two-dimensional laparoscopic cholecystectomy: is surgeon experience relevant? J Laparoendosc Adv Surg Tech A 2015; 25:566–570

  10. Sahu D, Mathew MJ, Reddy PK (2014) 3D laparoscopy - help or hype; initial experience of a tertiary health centre. JCDR. 8(7):NC01–NC03. https://doi.org/10.7860/JCDR/2014/8234.4543

    Article  PubMed  Google Scholar 

  11. Koppatz H, Harju J, Siren J et al (2019) Three-dimensional versus two-dimensional high-definition laparoscopy in cholecystectomy: a prospective randomized controlled study. Surg Endosc 33(11):3725–3731

    Article  Google Scholar 

  12. Schwab KE, Curtis NJ, Whyte MB, Smith RV, Rockall TA, Ballard K, Jourdan IC (2020) 3D laparoscopy does not reduce operative duration or errors in day-case laparoscopic cholecystectomy: a randomised controlled trial. Surg Endosc 34(4):1745–1753

    Article  Google Scholar 

  13. Li L, Gao X, Guo Y, Luo Y, Luo Y, Yang X, Zhang W, Feng L (2019) Comparison of three-dimensional versus two-dimensional laparoscopic surgery for rectal cancer: a meta-analysis. Int J Color Dis 34:1577–1583. https://doi.org/10.1007/s00384-019-03353-8

    Article  Google Scholar 

  14. Pantalos G, Patsouras D, Spartalis E et al (2020) Three-dimensional versus two-dimensional laparoscopic surgery for colorectal cancer: systematic review and meta-analysis. Vivo. 34(1):11–21

    Article  Google Scholar 

  15. Liang H, Liang W, Lei Z et al (2018) Three-dimensional versus two-dimensional video-assisted endoscopic surgery: a meta-analysis of clinical data. World J Surg 42:3658–3668. https://doi.org/10.1007/s00268-018-4681-z

    Article  PubMed  Google Scholar 

  16. Peponis T, Eskesen TG, Mesar T, Saillant N, Kaafarani HMA, Yeh DD, Fagenholz PJ, de Moya MA, King DR, Velmahos GC (2018) Bile spillage as a risk factor for surgical site infection after laparoscopic cholecystectomy: a prospective study of 1,001 patients. J Am Coll Surg 226(6):1030–1035. https://doi.org/10.1016/j.jamcollsurg.2017.11.025

    Article  PubMed  Google Scholar 

  17. Misra M, Schiff J, Rendon J, et al (2015) Laparoscopic cholecystectomy after the learning curve. Surg Endosc 2005;19:1266–1271

  18. Lukovich P, Zsirka A, Harsanyi L (2014) Changes in the operating time of laparoscopic cholecystectomy of the surgeons and novices between 1994–2012. Chirurgia. 109:639–643

    PubMed  CAS  Google Scholar 

  19. Grau-Talens EJ, Motos-Micó JJ, Giraldo-Rubio R, Aparicio-Gallego JM, Salgado JF, Ibáñez CD, Mangione-Castro PG, Arribas-Jurado M, Jordán-Chaves C, Arias-Díaz J (2018) Small-incision cholecystectomy (through a cylinder retractor) under local anaesthesia and sedation: a prospective observational study of five hundred consecutive cases. Langenbeck's Arch Surg 403(6):733–740. https://doi.org/10.1007/s00423-018-1707-9

    Article  Google Scholar 

  20. Hozo S, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13

    Article  Google Scholar 

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Author information

Author notes

  1. Sian Davies and Mohammed Ghallab equally contributed to this paper and joint first authorship is proposed.

Authors and Affiliations

  1. Department of General Surgery, The Shrewsbury and Telford Hospital NHS Trust, Telford, UK

    Sian Davies

  2. Department of Hepato-Pancreato-Biliary and Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

    Mohammed Ghallab

  3. Department of General Surgery, Glan Clwyd Hospital, Rhyl, Denbighshire, UK

    Shahab Hajibandeh

  4. Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK

    Shahin Hajibandeh

  5. Department of General and Colorectal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

    Sarah Addison

Authors
  1. Sian Davies
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  2. Mohammed Ghallab
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  3. Shahab Hajibandeh
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  4. Shahin Hajibandeh
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  5. Sarah Addison
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Contributions

Conception and design: Shahin H. Literature search and study selection: SD and MG. Data collection: SD, MG, Shahab H and Shahin H. Analysis and interpretation: Shahin H and Shahab H. Writing the article: SD, MG and Shahin H. Critical revision of the article: all authors. Final approval of the article: all authors. Statistical analysis: Shahin H and Shahab H.

Corresponding author

Correspondence to Shahin Hajibandeh.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Considering the design of our study, ethical approval and consent were not required.

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Appendix

Appendix

Table 1 Search strategy

Search no.

Search strategy*

#1

MeSH descriptor: [cholecystectomy] explode all trees

#2

cholecystectomy: TI,AB,KW

#3

MeSH descriptor: [Laparoscopic cholecystectomy] explode all trees

#4

Laparoscopic cholecystectomy: TI,AB,KW

#5

#1 OR #2 OR #3 OR #4

#6

MeSH descriptor: [3 dimensional ] explode all trees

#7

3 dimensional : TI,AB,KW

#8

MeSH descriptor: [3D ] explode all trees

#9

3D : TI,AB,KW

#10

MeSH descriptor: [2 dimensional ] explode all trees

#11

2 dimensional : TI,AB,KW

#12

MeSH descriptor: [2D] explode all trees

#13

2D : TI,AB,KW

#14

MeSH descriptor: [three-dimensional] explode all trees

#15

three-dimensional : TI,AB,KW

#16

MeSH descriptor: [ two-dimensional ] explode all trees

#17

two-dimensional : TI,AB,KW

#18

#6 OR #7 OR #8 OR #9 #10 OR #11 OR #12 OR #13 #14 OR #15 OR #16 OR #17

#19

#5 AND #18

  1. *This search strategy was adopted for following databases: MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL)

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Davies, S., Ghallab, M., Hajibandeh, S. et al. Three-dimensional versus two-dimensional imaging during laparoscopic cholecystectomy: a systematic review and meta-analysis of randomised controlled trials. Langenbecks Arch Surg 405, 563–572 (2020). https://doi.org/10.1007/s00423-020-01909-9

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  • DOI: https://doi.org/10.1007/s00423-020-01909-9

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