Impact of Three-Dimensional Visualization Technology in Laparoscopic Cholecystectomy

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Background Three-dimensional (3D) visualization (3DV) may improve operative performance and outcomes during laparoscopy. The difficulty of laparoscopic cholecystectomy (LC) considerably varies depending on the inflammation or anatomical findings; additionally, its performance also differs depending on the surgeon’s skills. However, studies comparing the effectiveness of LC with 3DV (3D-LC) to that of two-dimensional (2D) visualization (2D-LC) remain limited. Methods Consecutive patients who underwent LC at our hospital were retrospectively assessed. The patients were classified into 3D-LC and 2D-LC groups depending on the imaging modality used, and their characteristics and outcomes were compared. Additionally, logistic regression analysis of the impact of the imaging modality (2D vs 3D) on each operative outcome was performed. Results Of 295 participants, 129 underwent 2D-LC and 165 underwent 3D-LC. There were no significant differences in operative outcomes between the 2 groups, except for the rate of drain placement. In the logistic regression analysis, 3DV potentially reduced intraoperative blood loss (odds ratio: 0.491; 95% CI: 0.269-0.899; P = .023 ). In the logistic regression analysis of the preoperative factors for intraoperative increased blood loss, 2DV was identified as an independent risk factor for increased intraoperative blood loss in multivariate analysis (odds ratio: 3.513; 95% CI: 1.745-7.072; P < .001 ). Conclusion Three-dimensional visualization did not significantly affect LC; however, it contributed to the reduction in blood loss and drain placement rates.