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
Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Pontevedra Instituto de Investigación, Sanitaria Galicia Sur, Pontevedra, Spain.
Jefe de Servicio de Cirugía General y Digestiva, Complejo Hospitalario de Pontevedra, Carretera de Mourente s/n, 36071, Pontevedra, Spain.
Obes Surg. 2017 Oct;27(10):2552-2556. doi: 10.1007/s11695-017-2687-5.
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.
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.
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).
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.
3D腹腔镜技术使外科医生能够重新获得深度感知并提高准确性。本研究的目的是评估3D技术在减重手术中的影响。
进行了一项回顾性队列研究。纳入了2013年至2016年间所有接受减重手术（袖状胃切除术（SG）或胃旁路术（GB））的患者。我们比较了3D腹腔镜队列和2D腹腔镜队列。变量如下：年龄、性别、糖尿病、高血压、外科医生经验和干预类型。完成了手术时间、住院时间、中转、并发症、再次手术和死亡情况的比较。
共纳入312例连续患者。56.9%的患者接受了GB手术，43.1%接受了SG手术。总体并发症发生率为3.2%（瘘管2.5%，腹腔积血0.3%，其他0.4%）。3D队列进行了104例手术，2D队列进行了208例手术。2D队列和3D队列在以下方面相似：GB与SG的比例、年龄、性别、学习曲线、2型糖尿病、高血压和睡眠呼吸暂停。3D队列的手术时间和住院时间显著缩短（分别为144.07±58.07分钟和172.11±76.11分钟，5.12±9.6天和7.7±13.2天）。当我们按手术类型或外科医生经验对样本进行分层时，结果相同。在新手外科医生进行的手术中，3D队列的并发症减少（10.2%对1.8%，p = 0.034）。
在我们中心，3D腹腔镜技术在减重手术中的应用有助于缩短手术时间和住院时间，并提高手术安全性，无论是GB手术还是SG手术，对新手或经验更丰富的外科医生同样有利。
