The Comparison of 2D and 3D Systems in Total Laparoscopic Hysterectomy: a Systematic Review and Meta-analysis

Overview

Journal Arch Gynecol Obstet

Specialty Gynecology & Obstetrics

Date 2024 Aug 24

PMID 39180564

Authors

Can Tercan

Ali Can Gunes

Ercan Bastu

Christophe Blockeel

Fatih Aktoz

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the existing evidence regarding the comparison between 2 and 3D systems in Total Laparoscopic Hysterectomy (TLH) in terms of surgical outcomes.

Methods: A systematic review of electronic databases, including PubMed/MEDLINE and Web of Science, was conducted to identify relevant studies comparing 2D and 3D systems in TLH. The search employed a combination of Medical Subject Headings (MeSH) terms and keywords related to the topic. Studies meeting predefined criteria were included, while case reports and studies not directly comparing 2D and 3D systems were excluded. Two independent reviewers evaluated study eligibility and performed quality assessment. The quantitative synthesis was conducted using meta-analysis techniques.

Results: A statistically significant longer operation time in the 2D group compared to the 3D group (7 studies, mean difference [MD]: 13.67, 95% confidence interval [CI] 9.35-18.00, I = 16%). However, no statistically significant differences were found between the groups in terms of vaginal cuff closure time (2 studies, MD: 3.22, CI - 6.58-13.02, I = 96%), complication rate (7 studies, odds ratio [OD]: 1.74, CI 0.70-4.30, I = 0%), blood loss (3 studies, MD: 2.92, CI - 15.44-21.28, I = 0%), and Hb drop (3 studies, MD: 0.17, CI - 0.08-0.42, I = 1%).

Conclusion: Our results revealed a significant difference favoring 3D systems in operation time, while clinical outcomes between the two systems were found to be comparable in TLH. However, further research, particularly prospective studies with larger cohorts and longer-term follow-up, along with economic analyses, is needed to provide clinicians and healthcare decision-makers with essential guidance for practice and resource allocation.

References

Walsh C, Walsh S, Tang T, Slack M . Total abdominal hysterectomy versus total laparoscopic hysterectomy for benign disease: a meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2009; 144(1):3-7. DOI: 10.1016/j.ejogrb.2009.01.003. View

Della Corte L, Mercorio A, Palumbo M, Viciglione F, Cafasso V, Candice A . Minimally invasive anesthesia for laparoscopic hysterectomy: a case series. Arch Gynecol Obstet. 2022; 306(6):2001-2007. PMC: 9362356. DOI: 10.1007/s00404-022-06727-6. View

Tanagho Y, Andriole G, Paradis A, Madison K, Sandhu G, Varela J . 2D versus 3D visualization: impact on laparoscopic proficiency using the fundamentals of laparoscopic surgery skill set. J Laparoendosc Adv Surg Tech A. 2012; 22(9):865-70. DOI: 10.1089/lap.2012.0220. View

Storz P, Buess G, Kunert W, Kirschniak A . 3D HD versus 2D HD: surgical task efficiency in standardised phantom tasks. Surg Endosc. 2011; 26(5):1454-60. DOI: 10.1007/s00464-011-2055-9. View

Usta T, Karacan T, Naki M, Calik A, Turkgeldi L, Kasimogullari V . Comparison of 3-dimensional versus 2-dimensional laparoscopic vision system in total laparoscopic hysterectomy: a retrospective study. Arch Gynecol Obstet. 2014; 290(4):705-9. DOI: 10.1007/s00404-014-3253-1. View

Swenson C, Kamdar N, Harris J, Uppal S, Campbell Jr D, Morgan D . Comparison of robotic and other minimally invasive routes of hysterectomy for benign indications. Am J Obstet Gynecol. 2016; 215(5):650.e1-650.e8. PMC: 5086293. DOI: 10.1016/j.ajog.2016.06.027. View

Wright J, Ananth C, Tergas A, Herzog T, Burke W, Lewin S . An economic analysis of robotically assisted hysterectomy. Obstet Gynecol. 2014; 123(5):1038-1048. PMC: 4144857. DOI: 10.1097/AOG.0000000000000244. View

Wenzl R, Pateisky N, Husslein P . [First use of a 3D video-endoscope in gynecology]. Geburtshilfe Frauenheilkd. 1993; 53(11):776-8. DOI: 10.1055/s-2007-1023725. View

Sorensen S, Savran M, Konge L, Bjerrum F . Three-dimensional versus two-dimensional vision in laparoscopy: a systematic review. Surg Endosc. 2015; 30(1):11-23. DOI: 10.1007/s00464-015-4189-7. View

10.

Ding D, Jiang H, Nie J, Liu X, Guo S . Concurrent Learning Curves of 3-Dimensional and Robotic-Assisted Laparoscopic Radical Hysterectomy for Early-Stage Cervical Cancer Using 2-Dimensional Laparoscopic Radical Hysterectomy as a Benchmark: A Single Surgeon's Experience. Med Sci Monit. 2019; 25:5903-5919. PMC: 6698092. DOI: 10.12659/MSM.914952. View

11.

Arezzo A, Vettoretto N, Francis N, Bonino M, Curtis N, Amparore D . The use of 3D laparoscopic imaging systems in surgery: EAES consensus development conference 2018. Surg Endosc. 2018; 33(10):3251-3274. DOI: 10.1007/s00464-018-06612-x. View

12.

Stroup D, Berlin J, Morton S, Olkin I, Williamson G, Rennie D . Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000; 283(15):2008-12. DOI: 10.1001/jama.283.15.2008. View

13.

Luckett T, Phillips J, Johnson M, Garcia M, Bhattarai P, Carrieri-Kohlman V . Insights from Australians with respiratory disease living in the community with experience of self-managing through an emergency department 'near miss' for breathlessness: a strengths-based qualitative study. BMJ Open. 2017; 7(12):e017536. PMC: 5728255. DOI: 10.1136/bmjopen-2017-017536. View

14.

Pergialiotis V, Prodromidou A, Perrea D, Doumouchtsis S . The impact of subcutaneous tissue suturing at caesarean section on wound complications: a meta-analysis. BJOG. 2017; 124(7):1018-1025. DOI: 10.1111/1471-0528.14593. View

15.

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. PMC: 5956089. DOI: 10.5387/fms.2017-22. View

16.

Ajao M, Larsen C, Manoucheri E, Goggins E, Rask M, Cox M . Two-dimensional (2D) versus three-dimensional (3D) laparoscopy for vaginal cuff closure by surgeons-in-training: a randomized controlled trial. Surg Endosc. 2019; 34(3):1237-1243. DOI: 10.1007/s00464-019-06886-9. View

17.

Pokora K, Kowalczyk K, Wikarek A, Rodak M, Pedrys K, Wojtowicz M . Depressive Symptoms and Control of Emotions among Polish Women with Polycystic Ovary Syndrome. Int J Environ Res Public Health. 2022; 19(24). PMC: 9779637. DOI: 10.3390/ijerph192416871. View

18.

Song T, Kang D . A randomized, controlled trial comparing the clinical outcomes of 3D versus 2D laparoscopic hysterectomy. Wideochir Inne Tech Maloinwazyjne. 2022; 17(1):127-133. PMC: 8886463. DOI: 10.5114/wiitm.2021.105724. View

19.

Tercan C, Sivas M, Aktoz F . The effects of 3D/Full HD and 2D/Ultra HD imaging systems on suturing skills during total laparoscopic hysterectomy: a prospective cohort study. Arch Gynecol Obstet. 2024; 309(3):1027-1033. DOI: 10.1007/s00404-023-07335-8. View