Impact of Three-Dimensional Laparoscopy in a Bariatric Surgery Program: Influence in the Learning Curve

• Published in: Obesity surgery Vol. 27; no. 10; pp. 2552 - 2556
• Main Authors: Padin, Esther Mariño, Santos, Raquel Sánchez, Fernández, Sonia González, Jimenez, Antonia Brox, Fernández, Sergio Estevez, Dacosta, Ester Carrera, Duran, Agata Rial, Artime Rial, Maria, Dominguez Sanchez, Ivan
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.10.2017; Springer Nature B.V
• Subjects: 3-D technology; Adult; Bariatric Surgery - adverse effects; Bariatric Surgery - education; Bariatric Surgery - methods; Clinical Competence; Female; Gastrectomy - adverse effects; Gastrectomy - education; Gastrectomy - methods; Gastric Bypass - adverse effects; Gastric Bypass - education; Gastric Bypass - methods; Gastrointestinal surgery; Humans; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - education; Laparoscopy - methods; Learning Curve; Length of Stay; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity, Morbid - surgery; Operative Time; Original Contributions; Reoperation; Retrospective Studies; Surgeons - education; Surgeons - standards; Surgery; Surgical outcomes; Treatment Outcome; 3D-laparoscopy; Bariatric surgery
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-017-2687-5

Introduction 3D laparoscopy allows the surgeon to regain the sense of depth and improve accuracy. The aim of the study was to assess the impact of 3D in bariatric surgery. Patients and Methods A retrospective cohort study was conducted. All our patients who underwent bariatric surgery (sleeve gastrectomy (SG) or gastric bypass (GB)) between 2013 and 2016 were included. We compared 3D laparoscopy cohort and 2D laparoscopy cohort. Variables are as follows: age, sex, DM, hypertension, surgeon experience, and type of intervention. Comparisons of operative time, hospital stay, conversion, complications, reoperation, and exitus are completed. Results Three hundred twelve consecutive patients were included. 56.9% of patients underwent GB and 43.1% SG. Global complications were 3.2% (fistula 2.5%, hemoperitoneum 0.3%, others 0.4%). One hundred four procedures were performed in the 3D cohort and 208 in the 2D cohort. The 2D cohort and 3D cohort were similar regarding the following: percentage of GB vs SG, age, gender, learning curve, diabetes mellitus 2, hypertension, and sleep apnea. The operating time and hospital stay were significantly reduced in the 3D cohort (144.07 ± 58.07 vs 172.11 ± 76.11 min and 5.12 ± 9.6 vs 7.7 ± 13.2 days. It was the same when we stratified the sample by type of surgery or experience of the surgeon. Complications were reduced in the 3D cohort in the surgeries performed by novice surgeons (10.2 vs 1.8%, p  = 0.034). Conclusions The use of 3D laparoscopy in bariatric surgery in our center has helped reducing the operating time and hospital stay, and improving the safety of the surgery, either in GB or SG, being equally favorable in novice or more experienced surgeons.