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Randomized Controlled Trial
. 2022 Feb;407(1):105-112.
doi: 10.1007/s00423-021-02302-w. Epub 2021 Aug 30.

Comparison of laparoscopic gastrectomy with 3-D/HD and 2-D/4 K camera system for gastric cancer: a prospective randomized control study

Shingo Kanaji  1 , Yuta Yamazaki  2 , Takuya Kudo  2 , Hitoshi Harada  2 , Gosuke Takiguchi  2 , Naoki Urakawa  2 , Hiroshi Hasegawa  2 , Masashi Yamamoto  2 , Kimihiro Yamashita  2 , Takeru Matsuda  2 , Taro Oshikiri  2 , Tetsu Nakamura  2 , Satoshi Suzuki  2 , Yoshihiro Kakeji  2
Affiliations
Randomized Controlled Trial

Comparison of laparoscopic gastrectomy with 3-D/HD and 2-D/4 K camera system for gastric cancer: a prospective randomized control study

Shingo Kanaji et al. Langenbecks Arch Surg. 2022 Feb.

Abstract

Purpose: We conducted a prospective clinical control study to identify the best imaging technology among three-dimensional (3-D) high-definition (HD) stereovision and two-dimensional (2-D) ultra-high-resolution (4 K) technology and confirm their effects on surgical outcomes of laparoscopic gastrectomy for gastric cancer.

Methods: From April 2018 to August 2019, 50 patients were randomly classified into two groups based on the imaging technology (3-D/HD group = 25, 2-D/4 K = 25). After excluding eight patients based on laparoscopic findings, 42 patients were analyzed (3-D/HD group = 21, 2-D/4 K = 21). The primary endpoint was the operative time; the secondary endpoints were blood loss, postoperative infectious complications, and postoperative hospital stay.

Results: The patients' backgrounds were similar (sex, age, body mass index [BMI], stage, procedure, and extent of lymph node dissection). There were no significant differences in operative time (252 vs. 238 min, P = 0.70), total blood loss, postoperative infectious complications, and postoperative hospital stay between the two groups. However, video analysis of surgeries revealed a significantly shortened median operative time (18 vs. 25 min, P = 0.04) in the suturing step with 3-D/HD; the median number of camera cleaning procedures during suprapancreatic lymph node dissection was significantly lower with 2-D/4 K than with 3-D/HD (n = 4.4 vs. 2.8, P = 0.02).

Conclusion: 3-D/HD and 2-D/4 K laparoscopic radical gastrectomies provide similar surgical outcomes. However, the 3-D monitor reduces suturing time during reconstruction, while the 4 K monitor reduces the number of camera cleaning procedures during lymphadenectomy.

Trial registration: Registered in the University Hospital Medical Information Network Clinical Trials Registry (identification number 000029227).

Keywords: 2-D/4 K laparoscopy; 3-D/HD laparoscopy; Gastric cancer; Laparoscopic gastrectomy.

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References

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