title: Perioperative, pathologic, and early continence outcomes comparing three-dimensional and two-dimensional display systems for laparoscopic radical prostatectomy--a retrospective, single-surgeon study.
abstract: OBJECTIVE
  To examine perioperative, pathologic, and early continence outcomes of laparoscopic radical prostatectomy (RP) aided by a new-generation three-dimensional (3D) display system and compare them with those from the same operation aided by a conventional, two-dimensional (2D) display system.
  
  
  METHODS
  A total of 95 consecutive patients underwent laparoscopic RP for clinically localized prostate cancer (PC) by an experienced single surgeon from October 2009 to December 2012. Baseline characteristics, perioperative and pathologic variables, and continence data at 3 months after surgery were retrospectively reviewed from a prospectively maintained database. Categoric and continuous variables were compared using chi-square, Student t, and Wilcoxon rank-sum tests, as appropriate.
  
  
  RESULTS
  A total of 29 patients underwent laparoscopic RP using a 3D display system and 66 patients underwent laparoscopic RP using a 2D display system. The two groups were comparable for all clinical and pathologic variables. Mean total operative time for the 3D group was 131 minutes (standard deviation [SD]±18) compared with 190 (SD±31) for the 2D group (P<0.001). Mean time to perform the urethrovesical anastomosis was 28 minutes (SD±6) for the 3D group compared with 87 minutes (SD±17) for the 2D group (P<0.001). Blood loss was lower in the 3D group, and the difference was statistically significant (P<0.001). A statistically significant higher number of patients in the 3D group had early recovery of continence compared with patients in the 2D group (14/28 (50%) patients in the 3D group vs 16/64 (25%) patients in the 2D group, P=0.02).
  
  
  CONCLUSIONS
  Laparoscopic RP aided by a new-generation 3D display system is associated with shorter operative times, reduced blood loss, and higher early continence rates in comparison with that aided by a 2D display system. In particular when considering economic issues, 3D laparoscopic RP may represent an acceptable alternative to robot-assisted laparoscopic RP.
authors.affiliation: 1 Department of Urology, Bagcilar Training and Research Hospital , Istanbul, Turkey .
authors.forename: Serdar
authors.initials: S
authors.lastname: Aykan
authors.forename: Paras
authors.initials: P
authors.lastname: Singhal
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Nguyen
authors.forename: Akin
authors.initials: A
authors.lastname: Yigit
authors.forename: Murat
authors.initials: M
authors.lastname: Tuken
authors.forename: Emrah
authors.initials: E
authors.lastname: Yakut
authors.forename: Aykut
authors.initials: A
authors.lastname: Colakerol
authors.forename: Suhejb
authors.initials: S
authors.lastname: Sulejman
authors.forename: Atilla
authors.initials: A
authors.lastname: Semercioz
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods / Q000706:statistics & numerical data; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D015992:Body Mass Index; D016009:Chi-Square Distribution; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D014554:Urination / Q000502:physiology