Abstract Title
Three-dimensional versus two-dimensional vision in laparoscopy A systematic review


Stine Maya Dreier Srensen
Mona Meral Savran
Lars Konge
Flemming Bjerrum


10AA Surgery


CAMES – Copenhagen Academy for Medical Education, The Capital Region, Copenhagen, Denmark
Dept. of Gynecology, Rigshospitalet, University hospital of Copenhagen, Denmark

Take-home Messages

3D laparoscopy

  • Seems to improve speed and reduce performance  errors
  • Side-effects are less common with newer 3D technology


  • Clinical studies are needed as well as studies of higher quality in simulation settings

​​Laparoscopic surgery is more challenging compared with open surgery, in part because surgeons must operate in a three-dimensional space through a two-dimensional projection on a monitor, which results in loss of depth perception1-5. This is one of the challenges when learning laparoscopy for a novice surgeon. To counter this problem, 3D imaging for laparoscopy was developed6-8. A systematic review of the literature was performed to assess the effect of 3D laparoscopy










Figure 1: An example of novice surgeons training laparoscopy on the virtual reality simulator, Lapsim.

Summary of Work

A systematic search of the literature was conducted to identify randomized controlled trials (RCTs) that compared 3D with 2D laparoscopy. The search string was developed by the primary author with assistance from a research librarian. Selection of articles was based on pre-defined inclusion criteria.

Use the "more detail" button to see the full PRISMA flowchart.




Summary of Results

340 were screened for eligibility, and 31 were included in the review. Three trials were done in a clinical setting and 28 trials used a simulated setting. Time was used as an outcome measure in all of the trials, number of errors was used in19 out of 31 trials and 18 of the 31 trials examined side effects. 


Overall 3D laparoscopy appears to improve speed and reduce the number of performance errors when compared with 2D laparoscopy. Most studies to date assessed 3D laparoscopy in simulated settings, and the impact of 3D laparoscopy on clinical outcomes has yet to be examined.




We thank Henrik Hornemann, instruction and reference librarian at The Royal Library/KUBIS, Denmark, for his assistance with developing the search string.


Reference list; 

  1. Taffinder N, Smith SG, Huber J, Russell RC, Darzi A (1999) The effect of a second-generation 3D endoscope on the laparoscopic precision of novices and experienced surgeons. Surg Endosc 13(11):1087-1092  http://www.ncbi.nlm.nih.gov/pubmed/?term=PMID%3A+10556444
  2. Wilhelm D, Reiser S, Kohn N, Witte M, Leiner U, Mühlbach L, Ruschin D, Reiner W, Feussner H (2014) Comparative evaluation of HD 2D/3D laparoscopic monitors and benchmarking to a theoretically ideal 3D pseudodisplay: even well-experienced laparoscopists perform better with 3D. Surg Endosc 28(8): 2387-97 http://www.ncbi.nlm.nih.gov/pubmed/?term=PMID%3A+24651895
  3. Lusch A, Bucur PL, Menhadji AD, Okhunov Z, Liss MA, Perez-Lanzac A, McDougall EM, Landman J (2014) Evaluation of the impact of three-dimensional vision on laparoscopic performance. J Endourol 28(2):261-266 http://www.ncbi.nlm.nih.gov/pubmed/?term=PMID%3A+24059674
  4. Kong SH, Oh BM, Yoon H, Ahn HS, Lee HJ, Chung SG, Shiraishi N, Kitano S, Yang HK (2010) Comparison of two- and three-dimensional camera systems in laparoscopic performance: a novel 3D system with one camera. Surg Endosc 24(5):1132-1143 http://www.ncbi.nlm.nih.gov/pubmed/?term=PMID%3A+19911222
  5. Smith R, Schwab K, Day A, Rockall T, Ballard K, Bailey M, Jourdan I (2014) Effect of passive polarizing three-dimensional displays on surgical performance for experienced laparoscopic surgeons.  Br J Surg 101(11):1453-1459 http://www.ncbi.nlm.nih.gov/pubmed/?term=PMID%3A+25131843
  6. Sahu D, Mathew MJ, Reddy PK (2014) 3D Laparoscopy - Help or Hype; Initial Experience of A Tertiary Health Centre. J Clin Diagn Res  8(7):NC01-03 http://www.ncbi.nlm.nih.gov/pubmed/?term=PMID%3A+25177597
  7. Cicione A, Autorino R, Breda A, Sio MD, Damiano R, Fusco F, Greco F, Carvalho-Dias E, Mota P, Nogueira C, Pinho P, Mirone V, Correia-Pinto J, Rassweiler J, Lima E,(2013) Three-dimensional vs Standard Laparoscopy: Comparative Assessment Using a Validated Program for Laparoscopic Urologic Skills. Urology 82(6):1444-1450 http://www.ncbi.nlm.nih.gov/pubmed/?term=PMID%3A+24094658
  8. Alaraimi B, Bakbak W, Sarker S, Makkiyah S, Al-Marzouq A, Goriparthi R, Bouhelal A, Quan V, Patel B (2014) A Randomized Prospective Study Comparing Acquisition of Laparoscopic Skills in Three-Dimensional (3D) vs. Two-Dimensional (2D) Laparoscopy. World J Surg 38(11):2746-2752 http://www.ncbi.nlm.nih.gov/pubmed/?term=PMID%3A+25002241


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Take-home Messages
Summary of Work

Summary of Results




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