Total laparoscopic hysterectomyにおける2Dと3D内視鏡システムによる手術成績の比較

抄録

Objective: This study was conducted to analyze whether the 3-dimensional (3D) laparoscopic surgical systems can be used safely and efficiently for total laparoscopic hysterectomy (TLH) at our hospital.

Design: We retrospectively compared the outcomes of TLH using a 3D laparoscopic system to outcomes using the conventional 2-dimensinal (2D) laparoscopic system. From November 2014, when we began using the 3D laparoscopic system in our hospital, to December 2015, 47 TLHs were performed using the 3D laparoscopic system (3D-TLH) . The 3D-TLH outcomes were compared with the outcomes from 47 2D-TLHs performed just before the introduction of the 3D laparoscopic system.

Results: The 3D-TLH group had statistically significantly shorter mean operative time than the 2D-TLH group (119±20min. vs 137±20min.) , although the mean weight of resected uterus and the mean intraoperative blood loss were not statistically different. When we compared the outcomes for 20 cases in each group, using the same device in a short period of time, only mean operative time was statistically different between the 3D- and 2D-TLH groups. During the observation period, there was one occurrence of postoperative peritonitis in the 2D-TLH group and one occurrence of vagina cuff dehiscence in each group. The surgeon and surgical assistants did not report any symptoms that were attributable to the 3D imaging system such as dizziness, eyestrain, nausea, and headache.

Conclusion: The 3D laparoscopic system, which had been developed to account for the lack of depth perception, can be used safely and efficiently for TLH at our hospital.