Three-dimensional versus two-dimensional laparoscopy for ovarian cystectomy: A prospective randomised study

Abstract

Introduction: Three-dimensional (3D) laparoscopy is now available as an alternative to conventional two-dimensional (2D) laparoscopy for ovarian cystectomy. However, the clinical value of 3D laparoscopy in benign gynaecological surgery remains uncertain. This study evaluated whether 3D laparoscopy had any advantages over 2D laparoscopy for ovarian cystectomy for apparently benign ovarian cysts. Methods: This prospective randomised study involved patients undergoing laparoscopic ovarian cystectomy. The primary outcomes were the duration of cystectomy and surgeon’s Global Operative Assessment of Laparoscopic Skills (GOALS) score. The secondary outcomes were the preferences, perceptions, and adverse effects reported by the participating surgeons. Results: There were 38 patients assigned to the 2D laparoscopy group and 37 patients assigned to the 3D laparoscopy group. Participating surgeons in the 2D group reported more efficient tissue handling than did those in the 3D group (mean [standard deviation] rating score, 4.2 [0.8] vs 3.8 [0.8]; P=0.033). Duration of cystectomy (47.6 [32.0] min vs 51.6 [36.2] min; P=0.198) and overall GOALS score (20.8 [3.9] vs 20.1 [3.3]; P=0.393) were similar between both groups. Participating surgeons in the 2D group reported nausea, dizziness, ocular fatigue, and blurring of vision less frequently than did those in the 3D group (5.3% vs 45.9%; P<0.001). Conclusion: There were no significant benefits to using 3D laparoscopy compared with conventional 2D laparoscopy for ovarian cystectomy, and 3D laparoscopy may cause more frequent adverse effects in surgeons.