BACKGROUND Laparoscopic surgery has well-established benefits for patients; however, laparoscopic procedures have a long and difficult learning curve, in large part due to the lack of stereoscopic depth perception. Developments in high-definition and stereoscopic imaging have attempted to overcome this. Three-dimensional high-definition (3D HD) systems are thought to improve operating times compared to two-dimensional high-definition systems. However their performance against new, ultra-high-definition ('4K') systems is not known. METHODS Patients undergoing laparoscopic cholecystectomy were randomised to 3D HD or 4K laparoscopy. Operative videos were recorded, and the time from gallbladder exposure to separation from the liver (minus on table cholangiogram) was calculated. Blinded video assessment was performed to calculate intraoperative error scores. RESULTS One hundred and twenty patients were randomised, of which 109 were analysed (3D HD n = 54; 4K n = 55). No reduction in operative time was detected with 3D HD compared to 4K laparoscopy (median [IQR]; 23.41 min [17.00-37.98] vs 20.90 min [17.67-33.03]; p = 0.91); nor was there any decrease observed in error scores (60 [56-62] vs 58 [56-60]; p = 0.27), complications or reattendance. Stone spillage occurred more frequently with 3D HD, but there were no other differences in individual error rates. Gallbladder grade and operating surgeon had significant effects on time to complete the operation. Gallbladder grade also had a significant effect on the error score. CONCLUSIONS A 3D HD laparoscopic system did not reduce operative time or error scores during laparoscopic cholecystectomy compared with a new 4K imaging system.

中文翻译：

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3D 比 4K 腹腔镜胆囊切除术更快、更安全吗？一项随机对照试验。

背景技术腹腔镜手术对患者来说具有明确的益处。然而，腹腔镜手术的学习曲线漫长且困难，很大程度上是由于缺乏立体深度感知。高清和立体成像的发展试图克服这个问题。与二维高清系统相比，三维高清 (3D HD) 系统被认为可以缩短运行时间。然而，它们针对新的超高清（“4K”）系统的性能尚不清楚。方法 接受腹腔镜胆囊切除术的患者被随机分配接受 3D HD 或 4K 腹腔镜检查。记录手术视频，并计算从胆囊暴露到与肝脏分离的时间（减去桌上胆管造影）。进行盲视频评估以计算术中错误评分。结果 120 名患者被随机分组​​，其中 109 名进行了分析（3D HD n = 54；4K n = 55）。与 4K 腹腔镜检查相比，3D HD 未发现手术时间缩短（中位 [IQR]；23.41 分钟 [17.00-37.98] vs 20.90 分钟 [17.67-33.03]；p = 0.91）；错误评分（60 [56-62] vs 58 [56-60]；p = 0.27）、并发症或再就诊也没有观察到任何减少。使用 3D HD 时，石头溢出的情况更频繁，但个体错误率没有其他差异。胆囊分级和手术医生对完成手术的时间有显着影响。胆囊分级对错误评分也有显着影响。结论 与新的 4K 成像系统相比，3D HD 腹腔镜系统并未减少腹腔镜胆囊切除术的手术时间或错误评分。