Pavone M, Di Berardino S, Esposito G, Baroni A, D'Indinosante M, Giudice M T, Gioé A, Campolo F, Catena U, Scambia G, Fanfani F, Restaino S
Facts Views Vis Obgyn. 2024 Sep;16(3):317-323. doi: 10.52054/FVVO.16.3.029.
Technological advances in visual systems have contributed to overcoming the limitations in spatial perception of minimally invasive techniques. To date, there is a lack of literature on the advantages of 3D vision systems over 4K in laparoscopic surgery, although benefits have been observed in the training setting.
To compare operating times, perioperative outcomes, and task achievement using 3D and 4K vision systems for vaginal cuff closure performed by residents during total laparoscopic hysterectomy (TLH). All surgeons in training have obtained the Gynaecological Endoscopic Surgical Education and Assessment (GESEA) certificate.
This is a prospective randomised trial (NCT04637022). Women undergoing total hysterectomies for benign conditions between January 2021 and November 2023 were enrolled in the study. Vaginal cuff closures were performed by surgeons in training who had obtained the second level of the GESEA programme certificate.
Fifty-four patients were enrolled. There were no statistically significant differences in time between 3D and 4K vision for vaginal cuff closure (p=0.918). No statistically significant differences were observed for mean estimated blood loss (EBL) (overall: 62.85 ± 22.73mL; 3D: 65 ± 24.83mL; 4K: 61.11 ± 21.18; p=0.556) and median hospital stay (p=0.234). Three non-severe intraoperative complications in the 3D group (p=0.048) and three postoperative complications in the entire cohort (p=0.685) were reported.
The operating time for vaginal cuff closure performed by trainee surgeons is similar when comparing 3D vision during conventional laparoscopy and 4K vision systems. The choice of surgical vision systems may be guided by a cost analysis and surgeon preferences.
WHAT IS NEW?: Substantial evidence is lacking regarding the advantages of incorporating 3D vision into standard laparoscopy for gynaecological surgery. This research seeks to assess whether the 3D visual system can provide benefits as compared to 4K visualisation during laparoscopic vaginal cuff closure performed by surgeons in training within the GESEA 2 certification programme.
视觉系统的技术进步有助于克服微创手术空间感知方面的局限性。尽管在培训环境中已观察到一些益处，但迄今为止，关于腹腔镜手术中3D视觉系统相对于4K视觉系统优势的文献尚少。
比较住院医师在全腹腔镜子宫切除术（TLH）中使用3D和4K视觉系统进行阴道断端闭合的手术时间、围手术期结局和任务完成情况。所有参与培训的外科医生均已获得妇科内镜手术教育与评估（GESEA）证书。
这是一项前瞻性随机试验（NCT04637022）。纳入2021年1月至2023年11月期间因良性疾病接受全子宫切除术的女性。阴道断端闭合由已获得GESEA项目二级证书的培训外科医生完成。
共纳入54例患者。3D和4K视觉系统进行阴道断端闭合的时间无统计学显著差异（p=0.918）。平均估计失血量（EBL）（总体：62.85±22.73mL；3D：65±24.83mL；4K：61.11±21.18；p=0.556）和中位住院时间无统计学显著差异（p=0.234）。3D组报告了3例非严重术中并发症（p=0.048），整个队列报告了3例术后并发症（p=0.685）。
比较传统腹腔镜手术中的3D视觉和4K视觉系统时，实习外科医生进行阴道断端闭合的手术时间相似。手术视觉系统的选择可通过成本分析和外科医生偏好来指导。
新发现是什么？：关于将3D视觉纳入妇科手术标准腹腔镜的优势，缺乏充分证据。本研究旨在评估在GESEA 2认证项目中，培训外科医生进行腹腔镜阴道断端闭合时，3D视觉系统与4K可视化相比是否能带来益处。
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