title: Three-Dimensional Versus Two-Dimensional Laparoscopic Cholecystectomy: Is Surgeon Experience Relevant?
abstract: BACKGROUND
  A prospective randomized comparison of three-dimensional (3D) versus two-dimensional (2D) imaging during elective laparoscopic cholecystectomy (LC), both performed separately by an advanced laparoscopic surgeon and by a surgeon experienced in open surgical procedures but a novice at laparoscopic procedures, was designed to address the issue of whether 3D systems offer real operative time advantages to this laparoscopic procedure.
  
  
  METHODS
  Eighty patients were randomized the day of surgery by random computer-generated allocation list to receive either a 3D or 2D high-definition imaging system LC by two surgeons with differing experience. After the insertion of the access ports the surgical procedure was divided in two component tasks. Operative times of the two component tasks and the entire procedure were recorded.
  
  
  RESULTS
  The execution times for the two component tasks and the entire procedure were not significantly different between the 2D and 3D groups for the experienced laparoscopic surgeon. However, the execution times for the two component tasks and the entire procedure were significantly faster during 3D compared with 2D for the novice surgeon. Both surgeons experienced better depth perception with the 3D system and subjectively reported less strain using 3D rather than 2D vision.
  
  
  CONCLUSIONS
  3D imaging seems not to influence the performance time of LC by an experienced laparoscopic surgeon. Less experienced laparoscopic surgeons could benefit from shorter performance time with 3D imaging due to no need to adapt to 2D vision. Further comparative studies are necessary to verify on great numbers of cases whether 3D can reduce intraoperative complications such as biliary lesions.
authors.affiliation: Department of Human Pathology, University Hospital of Messina , Messina, Italy .
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Currò
authors.affiliation: Department of Human Pathology, University Hospital of Messina , Messina, Italy .
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Malfa
authors.affiliation: Department of Human Pathology, University Hospital of Messina , Messina, Italy .
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lazzara
authors.affiliation: Department of Human Pathology, University Hospital of Messina , Messina, Italy .
authors.forename: Antonio
authors.initials: A
authors.lastname: Caizzone
authors.affiliation: Department of Human Pathology, University Hospital of Messina , Messina, Italy .
authors.forename: Anna
authors.initials: A
authors.lastname: Fortugno
authors.affiliation: Department of Human Pathology, University Hospital of Messina , Messina, Italy .
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Navarra
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation*; D002983:Clinical Competence; D003867:Depth Perception; D017558:Elective Surgical Procedures / Q000295:instrumentation; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies