{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:44:09Z","timestamp":1792086249149,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021071","name":"Faculty of Medicine and Health, University of Sydney","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>3D visualization systems in laparoscopic surgery have been proposed to improve manual task handling compared to 2D, however, few studies have compared the intra\u2010operative efficacy in laparoscopic cholecystectomy (LC). The aim of this study is to determine if there is a benefit in intra\u2010operative efficiency when using a 3D visualization system in difficult LC compared to traditional 2D visualization systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<jats:bold>s<\/jats:bold><\/jats:title><jats:p>Retrospective analysis of \u2018difficult\u2019 LCs (Grades 3 or 4) was completed. The assessor was blinded as all cases were recorded and viewed in 2D only. Variables collected included time to complete steps, missed hook diathermy attempts, failed grasp attempts, missed clip attempts and preparation steps for intra\u2010operative cholangiogram (IOC). Multiple linear regression was undertaken for time variables, Poisson regression or negative binomial regression was completed for continuous variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two operative videos of \u2018difficult\u2019 LC were reviewed. 3D systems were associated with reduced operative times, although this was not statistically significant (CI: \u22122.93\u201314.93, <jats:italic>P<\/jats:italic>\u2010value\u2009=\u20090.183). Dissection of the anterior fold to achieve the critical view of safety was significantly faster by 3.55\u2009min (CI: 1.215\u20139.206, <jats:italic>P<\/jats:italic>\u2010value\u2009=\u20090.002), and with considerably fewer errors when using 3D systems. Fewer IOC preparation errors were observed with a 3D system compared with a 2D system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>3D systems appear to enhance operator efficiency, allowing faster completion of critical steps with fewer errors. This pilot study underscores the utility of video annotation for intra\u2010operative assessment and suggests that, in larger multi\u2010centre studies, 3D systems may demonstrate superior intra\u2010operative efficiency over 2D systems during a \u2018difficult\u2019 LC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18949","type":"journal-article","created":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T06:11:31Z","timestamp":1710569491000},"page":"1114-1121","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["<scp>3D<\/scp> visualization systems improve operator efficiency during difficult laparoscopic cholecystectomy: a retrospective blinded review of surgical videos"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1039-902X","authenticated-orcid":false,"given":"Meet","family":"Patel","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney  Camperdown New South Wales Australia"},{"name":"Northern Beaches Hospital  Frenches Forrest New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3270-0832","authenticated-orcid":false,"given":"Isaac","family":"Tranter\u2010Entwistle","sequence":"additional","affiliation":[{"name":"Department of Surgery and Critical Care The University of Otago  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4295-422X","authenticated-orcid":false,"given":"Pramudith","family":"Sirimanna","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6690-342X","authenticated-orcid":false,"given":"Thomas J","family":"Hugh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney  Camperdown New South Wales Australia"},{"name":"Upper Gastrointestinal Surgical Unit Royal North Shore Hospital and North Shore Private Hospital  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"OECD.Healthcare Utilisation: Surgical procedures2020[Cited 20 Aug 2023.] Available from URL:https:\/\/stats.oecd.org\/index.aspx?queryid=30167#."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2017.0155"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-020-01909-9"},{"key":"e_1_2_10_5_1","first-page":"101","article-title":"An analysis of the problem of biliary injury during laparoscopic cholecystectomy","volume":"180","author":"Strasberg SM","year":"1995","journal-title":"J. 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