title: Three-dimensional laparoscopy and thoracoscopy in children and adults: A prospective clinical trial.
abstract: BACKGROUND
  Laparoscopic procedures for children and adults already provide many advantages in two-dimensional (2D) vision. Only limited experiences exist for laparoscopic three-dimensional (3D) procedures in vivo. The aim of this prospective trial was to identify indications and limitations of the 3D-system in laparoscopic minimally invasive procedures in children and adults.
  
  
  METHODS
  In a prospective quality assurance for laparoscopic 3D evaluation in children and adults, a total of 53 consecutive patients (22 children, 31 adults) were included. Laparoscopic transabdominal, retroperitoneal and thoracoscopic procedures were performed. For laparoscopic 3D imaging a Camera Control Unit (CCU), 3D monitor and 3D-TIPCAM® were used. Patient data, operative procedures and image quality of the 3D system were assessed.
  
  
  RESULTS
  Of 53 patients, 22/53 were children and 31/53 adults with a mean age of 7.6 years (range, 10 months to 15 years) and 51.5 years (range, 18 to 79 years), respectively. 8/22 children were two years old or younger. No relevant difficulties occurred with nausea, fatigue, vertigo, eye blurring or double vision, burning eyes, visual fatigue, inconvenience of visual adaptation of 3D to 2D, or medical discomforts for the surgeons in both children and adults. Difficulties were mainly addressed to the small distance of the video endoscope and the organ tissue in small children and affected mainly image definition, resolution and eye focusing.
  
  
  CONCLUSIONS
  Advantages of 3D over 2D were mainly considered to be of relevant benefit in adults. Subjective advantages were seen in children and adults for stereoscopic depth perception, better visualization of anatomical structures and understanding of the anatomy, as well as for complex maneuvers such as suturing.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen , Tuebingen , Germany.
authors.forename: Marty
authors.initials: M
authors.lastname: Zdichavsky
authors.forename: Andreas
authors.initials: A
authors.lastname: Schmidt
authors.forename: Tobias
authors.initials: T
authors.lastname: Luithle
authors.forename: Sebastian
authors.initials: S
authors.lastname: Manncke
authors.forename: Jörg
authors.initials: J
authors.lastname: Fuchs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003867:Depth Perception; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D013906:Thoracoscopy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D055815:Young Adult
keywords: Three-dimensional (3D); adults; children; laparoscopy; pediatric surgery; thoracoscopy