Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea.
Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
Langenbecks Arch Surg. 2021 Mar;406(2):473-478. doi: 10.1007/s00423-020-01952-6. Epub 2020 Aug 3.
There are currently no reports on the application of three-dimensional (3D) vision to single-incision laparoscopic surgery. This study compared 3D vision to the previous two-dimensional (2D) system in single-incision laparoscopic distal gastrectomy (SIDG).
Medical charts of 179 gastric cancer patients who underwent SIDG from February 2014 to December 2017 were retrospectively reviewed. Patients were grouped into either a 2D group or 3D group depending on the type of camera that was used. All operations were performed using a flexible camera (Olympus, Japan). Operative data and postoperative outcome were analyzed.
There were 90 patients in the 2D group and 89 patients in the 3D group. No differences were found in terms of the age, body mass index, staging, and other demographics of the patients. Operative time was significantly faster in the 3D group (115.6 ± 34.0 vs. 129.4 ± 38.5 min, p = 0.012), and estimated blood loss (EBL) was less in the 3D group (20.7 ± 30.0 vs. 35.1 ± 56.0 ml, p = 0.034). Patients in the 3D group were able to start a small fluid diet earlier (2.5, range 1-6 vs. 3.0, range 2-8 postoperative days, p = 0.006) and were discharged faster (5.4, range 3-12 vs. 6.2, range 4-24 postoperative days, p = 0.024). There was no statistical difference between early and late complications.
The use of the 3D camera shortened operative time with possible clinical benefits for patients undergoing SIDG.
目前尚无将三维（3D）视觉应用于单切口腹腔镜手术的报道。本研究比较了 3D 视觉与单切口腹腔镜远端胃切除术（SIDG）之前的二维（2D）系统。
回顾性分析 2014 年 2 月至 2017 年 12 月期间 179 例胃癌患者接受 SIDG 的病历。根据使用的相机类型将患者分为 2D 组或 3D 组。所有手术均采用柔性相机（奥林巴斯，日本）进行。分析手术数据和术后结果。
2D 组 90 例，3D 组 89 例。两组患者年龄、体重指数、分期等一般资料比较差异无统计学意义。3D 组手术时间明显缩短（115.6±34.0 比 129.4±38.5 min，p=0.012），术中出血量（EBL）也较少（20.7±30.0 比 35.1±56.0 ml，p=0.034）。3D 组患者能更早开始小剂量液体饮食（2.5，范围 1-6 比 3.0，范围 2-8 天，p=0.006），更早出院（5.4，范围 3-12 比 6.2，范围 4-24 天，p=0.024）。早、晚期并发症发生率无统计学差异。
使用 3D 相机缩短了手术时间，可能对接受 SIDG 的患者具有临床益处。
