The verdict is clear

Comparison between 3D and 2D procedures

Laparoscopy is used to enable the visualization of organs and structures in the abdominal cavity. It is employed for diagnostic purposes and especially for performing surgery. The minimally invasive procedure results in less trauma during surgery and reduced postoperative pain. In addition, it lowers the risk of infection and avoids more extensive adhesions in the tissue. The comparison between 3D and 2D procedures was already an important developmental question several years ago and was investigated in various animal-based studies. ^[1]
3D visualization systems have been in existence for almost two decades, but the literature is now speaking of a renaissance in 3D imaging that has been underway for the last few years. More and more prominent manufacturers are bringing 3D systems to the market. In addition, critical enhancements in these systems have also led to growing demand for the technology, which also has had a positive effect on the prices. Foremost among these enhancements is the improved imaging they now provide as a result of expanded processing power in the systems – a development that also has occurred in digital microscopy. For visualizations of this quality twenty years ago, much larger and more expensive devices would have been required. ^[2] 3D laparoscopy systems are now available at acceptable prices. ^[3] A look in hospitals today shows that 3D laparoscopy is becoming more and more popular – not least because of how easy it is to learn, even for less experienced surgeons. ^[4]

Expanded range of operations and greater safety

The expanded range of operations that are being performed laparoscopically is most of all attributable to the improved imaging from the 3D systems. A recent clinical study by Baum et al. ^[5] investigated the effects of 3D laparoscopy on the efficacy and safety of gynecological procedures. Significant advantages were found in suturing and cutting of anatomical structures when using 3D visualization. In comparison to 2D laparoscopy, the surgeons found the representation of spatial depth particularly advantageous, an important reason for the improved safety levels in the operative procedures. The depiction of retroperitoneal neural structures was significantly improved. Improvements in the visualization of the uterus, ureter and blood vessels were not so pronounced. Despite this, Baum et al. draw a highly positive conclusion: Working with 3D laparoscopy provides surgeons with big advantages in comparison to 2D devices. The depiction of space shown in the images simply resembles the actual anatomy more closely. ^[5]

Depth perception – A big plus

Other studies come to similar conclusions. In a comparative study, 53 patients were treated for various surgical indications (including ovarian cyst, hernia and cholelithiasis). One group was operated using 3D laparoscopy, the other using 2D technology. The largest disadvantage of 2D laparoscopy is the lack of depth perception. This encumbers surgeons during operative procedures and can have a negative effect on safety. ^[6] The 3D group had a distinct advantage with significantly shorter time periods for the operations. The physicians cited the superior image quality particularly in respect to depth perception as the decisive factor for the more rapid procedures. ^[6]
Other advantages of the 3D technology are the good hand-eye coordination that it affords as well as increased precision. This allows surgeons to work more exactly and with fewer errors and to separate even exceedingly fine tissue structures. Less experienced surgeons benefit especially from these advantages. ^[7] They can learn the operations and the related anatomical features more quickly and effectively. The financial benefits for hospitals are obvious: In some cases, significantly shorter operation times reduce the amount of anesthetics that are required. In addition, existing laparoscopy instruments, for example all those that have a straight design, can also be used with the 3D technology. This lowers the investment as well as the maintenance costs. ^[7]