Using Three-Dimensional versus Two–Dimensional Laparoscopy in Sleeve Gastrectomy: A case matched comparison

ABSTRACT Background Laparoscopic sleeve gastrectomy using two-dimensional (2-D) systems has been proven to be a safe and effective treatment for obesity. Three-dimensional (3-D) systems have recently been introduced in the general field. We hypothesized that using a 3-D system offers more benefits than using 2-D laparoscopy in sleeve gastrectomy. Methods Patients who underwent laparoscopic sleeve gastrectomy (LSG) without any other surgeries between January 1st, 2017, and February 28th, 2019, were included. Characteristic factors and outcomes were reviewed and compared between the groups using the 2-D system and the 3-D system, including sex, age, length of stay (LOS), body mass index (BMI), operative time, blood loss, morbidity, total body weight loss, and excess weight loss. Results Seventy-five patients underwent LSG and were included in the study. Among them, forty-two patients used the 3-D system, while thirty-three patients used the 2-D system. There were no significant differences between the two groups in terms of basic characteristics, including age, sex, and BMI. The morbidity rate did not differ, but the 3-D group experienced less blood loss (25.12 ml vs. 47.27 ml; p = 0.001) and shorter operative times (105.93 ± 30.645 mins vs. 128.94 ± 28.566 mins; p = 0.001) compared to the 2-D group (25.12 ml vs. 47.27 ml; p = 0.001). Weight loss at 6 months was similar between the two groups. Conclusion In conclusion, 3-D LSG shows promise in reducing both blood loss and operative time. Nevertheless, further prospective trials are essential to definitively establish its efficacy.