Currently, there are over 1.7 billion people that are overweight worldwide. Surgical procedures like Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Roux-En-Y Gastric Bypass (LRGB) are effective, rapid, and sustainable treatments of obesity.
Traditional two-dimensional (2-D) laparoscopic imaging has always been the only option. Recently, a new three-dimensional technology pictures your body as a 3-D replica that adds layers of depth and spatial orientation not possible with 2D scans. By using a special monitor and eyeglasses, doctors can now perform gastric sleeve surgery in 3 dimensions.
Although studies show that this new technology increases overall results and reduces surgeon error – it’s not the preferred method by most bariatrician.
What is 3D laparoscopic surgery?
3-dimensional imaging allows a unique visualization that is useful in both small and deep scans of the human body. Some surgeons argue that the three-dimensional laparoscopic technique offers a better depth perception for higher accuracy, safer surgical procedures, and more precise cutting and stapling than its two-dimensional counterpart. However, many of our doctors have tried the virtual imaging system and still prefer a higher-quality 2-Dimensional monitor.
Watch as Dr. Christian Rodriguez Lopez test 3D laparoscopic imaging:
Equipment used for 3D gastric sleeve
In 2016, bariatric surgery had a breakthrough in 3D tomography (scanning). By wearing goggles or glasses, weight loss surgeons could perform all types of laparoscopic procedures with a complete scan of the patient’s anatomy. The tools required for a 3D sleeve gastrectomy include;
- High-resolution laparoscopic cameras
- High-density imaging system/screen
- Specialized glasses
Last year the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) scanned 25 bariatric patients 1 week before and 6 months after their procedure. By using a special 3D scanner, the team analyzed the changes in the patient’s stomach, waist, and abdomen before and after surgery.
Through these scans, the doctors proved how much weight the patient actually lost, which can be beneficial to their mental health and help them avoid withdrawals. This was not possible with traditional 2-dimensional renderings of natural vision and physical examinations.
Does 3D offer better results for bariatric surgery?
The use of three-dimensional laparoscopic technology is not widespread as it is currently limited to simulators and training facilities. In the case of gastric sleeve surgery, completing tasks like suturing wounds or examining the angle of their equipment may be easier with 3D technology. However, bariatrician’s around the world have not yet accepted it until certain functionality and visual aspects are improved in the technology.
Comparing three-dimensions with two-dimensions
The difference between high-definition 2D and lower-definition 3D is a highly debated topic in the medical community. Two-dimensional imaging such as a simple x-ray or CT scan is bright, saturated, and clear – typically more detailed than human eyesight. This is helpful as the inner body can be dark and look blended together during surgery.
On the other hand, three-dimensional imaging is more authentic and realistic in terms of what the surgeon would see with their own eyes. It adds the component of depth for the doctor that is not seen in a 4k or even 16k 2D screen. The tradeoff between the two options is that one is high-definition (HD) and the other is more realistic.
When choosing an imaging option, it is based on the surgeon’s learning curve and preference.
Regardless of the surgical devices used, it’s important for the surgeon to choose systems that allows for more precision, better recovery times, and lower risks and complications. Precision reduces complications.
Efficacy and results
One of the primary reasons surgeons prefer virtual rendering is the accuracy it provides to the operation. Not only is this kind of virtual reality imaging beneficial to bariatric surgery but it is also a good application for liver surgery, dental implants, and gynecological procedures. In these kinds of operations, the surgeon inserts a colored dye into the area which is needed to cut a uniquely-sized piece of the organ; however, this may be different every time.
“It’s like using one eye [2D] instead of two [3D].”
This kind of technology has also been used to identify complications and risks after bariatric surgery which would have been ignored or rejected otherwise. In Europe, 279 patients were given CT scans which were rendered into 3D renderings. In 21% of the patients studied, the scans revealed symptoms and significant details missed by previous tests.
Unfortunately for bariatric procedures, 3D imaging is not always effective. One concern surrounding 3D is that surgeons will grow too dependent on it. If the doctor needs to operate in a different hospital or operating room without 3D optics, it can be difficult to go back to 2D.
3D scans are also currently more expensive than 2D scans and take longer to develop. If the patient needs the procedure as soon as possible, 3D imaging may not be the right option for them. When it comes to choosing an imaging device, it is based on the surgeon’s preferences and resources and while 3D can be more effective, it is not always the best option for the patient.
- Resolution 3k (not 4k like the traditional monitors used by our surgeons)
- Easier and more comfortable for the surgeon
- More detailed and accurate
- Adds depth and spatial perception lacking in 2D imaging
- Quicker and more effective renderings
Many factors inhibit the 3D system to be as easy and simple for surgeons compared to 4k 2-D monitors. For example, 3-D monitors are less bright and saturated than the 4K 2-D monitors. Some of the negative side effects include;
- Looking through facial equipment can be inconvenient and exhausting for the surgeon
- Additional material in the patient’s body can cause possible complications and side effects
- Current 3-D monitors are not as bright as the 2-D monitors
- Not suitable for gastric sleeve
- Currently no 4k resolution
- Surgeons have experienced dizziness and nausea from the special glasses
- Increased cost for equipment
- Motion Blur
At Mexico Bariatric Center®, we currently use Stryker Laparoscopy Tower monitoring equipment which utilizes 2-dimensional scanning.