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- W2894912050 abstract "Background: Laparoscopic pancreatoduodenectomy(LPD) is a technically challenging procedure with concerns about higher rates of postoperative pancreatic fistula. Three-dimensional(3D) vision may especially improve surgical performance during construction of the pancreaticojejunostomy(PJ) and hepaticojejunostomy(HJ). Yet, data on the added value of 3D vision are lacking. Methods: We performed an experimental randomized controlled cross-over trial including 20 expert laparoscopic surgeons and 20 surgical residents capable of laparoscopic suturing. Participants performed a PJ and a HJ twice, using 3D- and 2D-laparoscopy on artificial organ models(LifeLike BioTissue®) according to the Pittsburgh method. Participants were randomized for the sequence of laparoscopy, i.e., 3D or 2D first. Primary endpoint was the time needed to complete both procedures. Secondary endpoints were surgical performance, assessed using a modified Birkmeyer scoring platform, and side-effects of 3D-laparoscopy. Results: A total of 71 HJs and 70 PJs were completed. The use of 3D-laparoscopy reduced the time to complete the PJ and HJ with 16.9%, from 84.0 to 68.3 minutes (median 15.1 minutes, CI -6.5- -24.3 min, P=0.002). Performance scoring increased with 3D-laparoscopy (mean 0.78 increase in 5-point Likert scale summary score, P=0.001). This effect was also seen in the subgroup of experts, including an increase in summary score. Of all participants, 97% stated to prefer 3D-laparoscopy, whereas 24.3% reported minor side effects, and 5.4% severe side effects (e.g. eye strain). Conclusion: 3D-laparoscopy, as compared to 2D, demonstrated substantial reduction in procedure time of completing both PJ and HJ in bio-tissue, and improved results in surgical performance grades for both experts and trained residents." @default.
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- W2894912050 date "2018-09-01" @default.
- W2894912050 modified "2023-10-13" @default.
- W2894912050 title "Additional value of 3d-vision during laparoscopic pancreatoduodenectomy bio tissue drills (LAELAPS 3D2D): A randomized controlled cross-over trial" @default.
- W2894912050 doi "https://doi.org/10.1016/j.hpb.2018.06.064" @default.
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