Evaluating the outcomes of 3D laparoscopic nephrectomy for bengin non-functioning kidneys

Abstract

Abstract Introduction: Previous endoscopic systems with 2D (2D) screens provide the surgeon with an indirect vision. To inprove this, 3D laparoscopic surgery was perfomed and has become a breakthrough in the era of minimally invasive surgery with high image definition, stability, good depth sense, reducing the burden on the surgeon's vision. At Hue Central Hospital, since 2020 we have applied regularly 3D endoscopic surgery for urological kidney diseases but not too many research projects to evaluate the safety, effectiveness and applicability of these means. Therefore, we carried out the topic: "Evaluating the results of 3D laparoscopic nephrectomy due to benign pathology". Patients and methods: 3D LN was performed on patients diagnosed with non-functioning kidneys at Hue central hospital from 1/2021 to 11/2021. Variables including standard features, clinical, subclinical, preoperative and postoperative results, perception of surgeons after surgery and how 3D vision impact their emotional states, were recorded. In addition, the duration of operation between high and low BMI groups as well as the adhesion inflammation level in kidney were also analyzed and compared. Results: Samples included 17 cases, with male:female is 6:11. Mean age was 58.18 11.66 (32-85). All cases were performed by transperitoneal laparoscopic nephrectomies. Mean operation time was 136,76 37,66 minutes, average blood loss was 85,0 21,36 ml (50-120). Mean length of stay was 8,88 3,44 days (5-18). Mean VAS score was 6,57 1,42. Complications had 3 cases: 2 cases had pyonephrosis, 1 case had acute pancreatitis without re-operated need. High BMI, hydronephrosis or nephritis didnt impact excessively on operation time. We recorded diversity of side effects from 3D lapararoscopy such as headache, nausea with some initial cases. Average STAI-6 score was 12,88 2,67. According to feeling of surgeons, they concurred with image quality, depth perception, eye-hand coordination during surgery were acceptable. Conclusion: 3D laparoscopic nephrectomy is safe, efficient. Using 3D vision for laparoscopy in order to obtain better image quality, has more depth and improve eye-hand coordination rather than 2D system. Keywords: Laparoscopic nephrectomy; 3D laparoscopy; non-functioning kidney.