3D laparoscopic partial nephrectomy in Australia: a pilot study

Abstract

Introduction and Objectives: Laparoscopic partial nephrectomy is a technically challenging procedure and important limitations with conventional laparoscopy include spatial orientation and depth perception. Three-dimensional (3D) video display has been introduced with robotic surgery, however the higher initial investment and associated running costs accompanying robotic technology makes it not cost-effective in certain centres. We developed a pilot study to compare the clinical outcomes of 3D laparoscopic partial nephrectomy with conventional twodimensional (2D) laparoscopic partial nephrectomy by a single surgeon in the ACT. The aim of this study was to assess whether 3D nephron-sparing laparoscopic surgery has better intraoperative and oncological outcomes compared to conventional 2D nephron-sparing laparoscopic surgery. Methods: Retrospective review of all consecutive patients who underwent laparoscopic partial nephrectomy since the introduction of a 3D video system at National Capital Private Hospital in 2012 under a single surgeon (HH). Clinical outcomes measured were the length of hospital stay, total operative time, blood transfusion, positive surgical margins and tumour margin clearance. These outcomes were measured for those patients that underwent 3D laparoscopic partial nephrectomy (LPN) and compared to historical data by the 110 © 2017 The Authors BJU International © 2017 BJU International | 119, Supplement 2, 82--118 110 Poster Abstracts same surgeon for patients that underwent conventional 2D LPN over the preceding 4 years. Statistical analysis of the data with chi-square and Fisher’s exact test was performed with SPSS v.23.0. Results: 22 patients were included in 3D laparoscopic partial nephrectomy (LPN) cohort with 17 patients included in the 2D LPN cohort. Conclusions: 3D laparoscopic partial nephrectomy is non-inferior to conventional 2D laparoscopic partial nephrectomy in our pilot study. The application of 3D technology in a training setting to decrease the learning curve for inexperienced laparoscopic surgeons is worth investigating. Show more