Three-dimensional versus two-dimensional laparoscopy for ovarian cystectomies: a prospective randomized study

Abstract

Objective: The purpose of this study was to evaluate whether the use of three-dimensional (3D) laparoscopy had any advantages over the conventional two-dimensional (2D) approach for ovarian cystectomies for apparently benign ovarian cysts. Methods: This was a prospective randomized studyinvolving women undergoing laparoscopic ovarian cystectomy. Women were randomized into two groups in which the ovarian cystectomy was performed either by 2D (2D group) or 3D laparoscopy (3D group). The primary outcome was the differences inglobal rating scores of the GlobalOperative Assessmentof Laparoscopic Skills (GOALS) assessment tool between the two groups. The secondary outcomeswere the duration of cystectomy, and surgeons' preferences and perceived side effects. Results: 38 and 37 women were respectively assigned to 2D and 3D group. Participants in 2D group reported more efficient tissue handling than in 3D group (rating score: 4.2+/−0.8 versus 3.8+/−0.8, p = 0.033). Duration ofcystectomy (47.6+/−32.0 minin 2D versus 51.6+/−36.2 min in 3D, p = 0.718), andsum of GOALS score (20.8+/−3.9 in 2D versus 20.1+/−3.3 in 3D, p = 0.393) were similar between the two groups. Surgeons from 2D group experienced less nausea, dizziness and ocular fatigue thanfrom 3D group (5.3 % in 2D versus 45.9 % in 3D, p < 0.0005). 43.3 % and 18.9 % of the 3D participants expressed their preference for 2D and 3D laparoscopy, respectively; while 37.8 % had no preference. Conclusions: 3D laparoscopy for ovarian cystectomies does not seem to achieve a significant benefit when compared to the conventional 2D laparoscopy and causes more side effectsto the surgeons.