title: Integrating Three-Dimensional Vision in Laparoscopy: The Learning Curve of an Expert.
abstract: OBJECTIVE
  Three-dimensional (3D) laparoscopy has been developed in an attempt to address one of the main limitations of laparoscopic surgery, which is two-dimensional (2D) vision. Still, data on the learning curve during adaptation of such technology in clinical practice are scarce. In this study, perioperative data from the initial operations performed by an experienced laparoscopic surgeon in a 3D laparoscopic setup are presented, aiming to document any difficulties faced during the integration of 3D vision to laparoscopy.
  
  
  METHODS
  In total, 15 consecutive, unselected cases were operated using 3D laparoscopy within a 30-day period. The cases included five laparoscopic extraperitoneal radical prostatectomies, three nephrectomies, three partial nephrectomies, one nephrouretectomy, one adrenalectomy, one ureterolithotomy, and one radical cystectomy with ureterocutaneostomies. Perioperative data were prospectively collected and analyzed.
  
  
  RESULTS
  The transition from 2D to 3D laparoscopy for the expert surgeon seemed to be very rapid without compromising the efficacy of the operation or patient safety. Perioperative outcomes and complications resembled the outcomes of our 2D experience.
  
  
  CONCLUSIONS
  Our preliminary experience with 3D laparoscopy was favorable, and we definitely opt for 3D vision in future operations. Nevertheless, current systems are related to several technical limitations that should be addressed to make even more appealing the further development of this technology. Whether the visual comfort offered by 3D vision during laparoscopy can be translated into an improvement in clinical outcomes offered to patients remains to be addressed in the future.
authors.affiliation: 1 Department of Urology, University of Patras , Patras, Greece .
authors.forename: Iason
authors.initials: I
authors.lastname: Kyriazis
authors.affiliation: 1 Department of Urology, University of Patras , Patras, Greece .|2 Department of Urology, Medical University of Vienna , Vienna, Austria .
authors.forename: Mehmet
authors.initials: M
authors.lastname: Özsoy
authors.affiliation: 1 Department of Urology, University of Patras , Patras, Greece .
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kallidonis
authors.affiliation: 1 Department of Urology, University of Patras , Patras, Greece .
authors.forename: Marinos
authors.initials: M
authors.lastname: Vasilas
authors.affiliation: 1 Department of Urology, University of Patras , Patras, Greece .
authors.forename: Vasilios
authors.initials: V
authors.lastname: Panagopoulos
authors.affiliation: 1 Department of Urology, University of Patras , Patras, Greece .
authors.forename: Evangelos
authors.initials: E
authors.lastname: Liatsikos
mesh_terms: D000368:Aged; D002983:Clinical Competence; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D011468:Prostatectomy / Q000379:methods; D016896:Treatment Outcome