Comparison of laparoscopic nephrectomy results with three-dimensional and two-dimensional imaging systems

Year 2022, Volume: 14 Issue: 1, 1 - 6, 31.01.2022

Hasan Nimetigil , İlker Şeçkiner , Özcan Sevim Mehmet Erturhan Haluk Şen

https://doi.org/10.54233/endouroloji.970301

Abstract

Objective: To evaluate the effects of three-dimensional (3D) and two-dimensional (2D) laparoscopic nephrectomies performed in a single center on intraoperative and early postoperative results.
Material and Methods: A total of 42 patients who were scheduled for laparoscopic nephrectomy in our clinic in 2019 and 2020 were included in the study. Transperitoneal laparoscopic simple/radical nephrectomy was performed in 21 patients (15 women, 6 men) with the 3D endovision system and in 21 patients (10 women, 11 men) with the 2D endovision system. Demographic characteristics of the patients (age, gender), operation time, the difference between preoperative and postoperative hemoglobin values, length of hospital stay, and complication rate were compared.
Results: Median age was 30 (9-74 years), mean operative time was 135.7 minutes, and the difference between preoperative hemoglobin value and postoperative hemoglobin value was calculated as 1.17 g/dl in 21 patients who used 2D. Radical nephrectomy was performed in 4 patients and simple nephrectomy in 17 patients. Clavien-Dindo grade 1 complication was seen in one patient.
The median age was 46 (16-73), the mean operative time was 128.6 minutes, and the difference between preoperative and postoperative hemoglobin values was 0.7 g/dl in 21 patients using 3D. Radical nephrectomy was performed in 10 patients and simple nephrectomy in 11 patients. No complications developed in the patients. In the comparison between the two groups, the difference between the preoperative hemoglobin value and the postoperative hemoglobin value was found to be significant (p: 0.041).
Conclusion: The depth perception provided by 3D endoscopic imaging systems allows for an easier understanding of anatomy and faster and easier dissection. With the ease of dissection, the amount of bleeding during the operation is reduced, bleeding areas are detected faster, and control can be achieved faster.

Keywords

three-dimensional, two-dimensional, laparoscopy, nephrectomy

Üç boyutlu ve iki boyutlu görüntüleme sistemleri ile yapılan laparaskopik nefrektomi sonuçlarının karşılaştırılması

Abstract

Amaç: Tek merkezde gerçekleştirdiğimiz laparaskopik nefrektomilerin üç boyutlu (3B) ve iki boyutlu (2B) sistemle uygulanmasının intraoperatif ve erken postoperatif sonuçlara etkisini değerlendirmek.
Gereç ve Yöntemler: Çalışmaya kliniğimizde 2019 ve 2020 yıllarında laparoskopik nefrektomi planlanan toplam 42 hasta dahil edildi. 3B endovizyon sistemi ile 21 hastaya (15 kadın, 6 erkek) 2B endovizyon sistemi ile 21 hastaya (10 kadın, 11 erkek) transperitoneal laparoskopik basit/radikal nefrektomi operasyonu yapıldı. Hastaların demografik özellikleri (yaş, cinsiyet), operasyon süresi, ameliyat öncesi hemoglobin değeri ile ameliyat sonrası hemoglobin değeri arasındaki fark, yatış süresi ve komplikasyon oranı karşılaştırıldı.
Bulgular: 2B kullanılan 21 hastada median yaş 30 (9-74), ortalama ameliyat süresi 135,7 dakika, ameliyat öncesi hemoglobin değeri ile ameliyat sonrası hemoglobin değeri arasındaki fark ortalama 1,17 gr/dl olarak hesaplandı. 4 hastaya radikal, 17 hastaya basit nefrektomi uygulandı. Bir hastada Clavien-Dindo derece 1 komplikasyon görüldü.
3B kullanılan 21 hastada median yaş 46 (16-73), ortalama ameliyat süresi 128,6 dakika, ameliyat öncesi hemoglobin değeri ile ameliyat sonrası hemoglobin değeri arasındaki fark 0,7 gr/dl olarak hesaplandı. 10 hastaya radikal, 11 hastaya basit nefrektomi uygulandı. Hastalarda komplikasyon gelişmedi. İki grup arası karşılaştırmada ameliyat öncesi hemoglobin değeri ile ameliyat sonrası hemoglobin değeri arasındaki fark anlamlı olarak bulundu (p: 0,041).
Sonuç: 3B endoskopik görüntüleme sistemlerinin sağlamış olduğu derinlik algısı anatominin daha kolay anlaşılmasına, diseksiyonun daha hızlı ve daha kolay yapılabilmesine olanak sağlamaktadır. Diseksiyon kolaylığı ile operasyon sırasındaki kanama miktarı azalmakta, kanama alanları daha hızlı saptanmakta ve kontrolü daha hızlı sağlanabilmektedir.

Keywords

iki boyutlu, üç boyutlu, laparoskopi, nefrektomi

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