Can 3D Imaging Improve Results in Colorectal Cancer Laparoscopic Surgery?

The aim of this prospective comparative study is to report our experience with 3D laparoscopy in terms of surgeon's discomfort with 3D vision, and to compare clinical outcomes with 2D laparoscopy in oncological colorectal surgery. From 2016 to 2017, all consecutive patients who underwent elective colorectal surgery for malignancy were enrolled. Based on surgery, patients were grouped as follows: group A, right hemicolectomy; group B, left hemicolectomy; group C, sigmoidectomy; and group D, anterior resection of the rectum. In total, 171 patients were included, of which 61 were in group A (45 3D and 16 2D), 18 in group B (15 3D and 3 2D), 44 in group C (30 3D and 14 2D) and 48 in group D (36 3D and 12 2D). The surgeon's discomfort did not occur due to the 3D vision. Complication rate and mean length of hospital stay (LOS) were lower in the 3D group in comparison to 2D, even if without statistically significant differences, in group B (6.6% versus 66.6% and LOS 6.1 ± 5.2 versus 23 ± 21 days), C (6.7% versus 21.4% and LOS 5.9 ± 2.5 versus 9 ± 8.4 days) and D (27.8% versus 50% and LOS 11.9 ± 16 versus 13 ± 11.8 days), respectively. Despite the lack of statistically significant differences between 2D and 3D laparoscopy, this study reports promising trends in favor of 3D laparoscopy, particularly for complex procedures such as anterior resection. Further randomized prospective studies with larger sample sizes and longer follow-up are necessary to conclusively determine the clinical impact of 3D laparoscopy in colorectal surgery.