{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:14:55Z","timestamp":1787238895976,"version":"build-2736575974"},"reference-count":30,"publisher":"American Veterinary Medical Association (AVMA)","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To evaluate the feasibility of a commercial simulator to reproduce key steps of canine laparoscopic cholecystectomy, and to compare surgical performance when using 3-D versus 2-D visualization.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 16 gallbladder inserts mounted in a laparoscopic cholecystectomy model were used. Inserts were randomly assigned to 2-D or 3-D visualization groups and placed in a laparoscopic training box. All procedures were performed on a single day in 2022 by 1 American College of Veterinary Surgeons resident who completed prestudy training on the simulator to minimize learning-curve effects. A board-certified surgeon supervised all procedures. Surgical steps included cystic duct dissection, endoclip application, cystic duct transection, and gallbladder removal. Measured outcomes included surgical times for defined intervals, total procedure time, intraoperative complications, and residual simulated liver tissue attached to the gallbladder.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Time from instrument insertion to first endoclip placement and total surgical time were significantly shorter with 3-D visualization compared to 2-D, and the differences in medians suggested clinically meaningful improvements in performance. There were no significant group differences in bile leakage, incomplete clipping, or the amount of residual foam attachment.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This physical simulator allowed reproduction of most key procedural steps in canine laparoscopic cholecystectomy. Three-dimensional visualization improved surgical efficiency for a trainee operator.<\/jats:p>\n <\/jats:sec>\n \n Clinical Relevance<\/jats:title>\n The simulator provided a safe, accessible platform for early skills acquisition before progressing to cadaveric or clinical training.<\/jats:p>\n <\/jats:sec>","DOI":"10.2460\/javma.25.09.0607","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T18:53:31Z","timestamp":1769021611000},"page":"1-5","source":"Crossref","is-referenced-by-count":1,"title":["A commercially available physical simulator can be used to teach canine laparoscopic cholecystectomy with 2-dimensional and 3-dimensional visualization"],"prefix":"10.2460","volume":"264","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1409-2052","authenticated-orcid":true,"given":"Kazushi","family":"Azuma","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0058-2210","authenticated-orcid":true,"given":"Eric","family":"Monnet","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"7","key":"ref1","series-title":"Vet Surg","first-page":"625","article-title":"Laparoscopic cholecystectomy for management of uncomplicated gall bladder mucocele in six dogs","volume":"37","author":"Mayhew PD","year":"2008","unstructured":"Mayhew PD, Mehler SJ, Radhakrishnan A. Laparoscopic cholecystectomy for management of uncomplicated gall bladder mucocele in six dogs. Vet Surg. 2008;37(7):625-630. doi:10.1111\/j.1532-950X.2008.00428.x"},{"issue":"suppl 1","key":"ref2","series-title":"Vet Surg","first-page":"O49","article-title":"Perioperative complications and outcome of laparoscopic cholecystectomy in 20 dogs","volume":"45","author":"Scott J","year":"2016","unstructured":"Scott J, Singh A, Mayhew PD, Perioperative complications and outcome of laparoscopic cholecystectomy in 20 dogs. Vet Surg. 2016;45(suppl 1):O49-O59. doi:10.1111\/vsu.12534"},{"issue":"11","key":"ref3","series-title":"J Vet Med Sci","first-page":"1747","article-title":"Short-term outcome of laparoscopic cholecystectomy for benign gall bladder diseases in 76 dogs","volume":"80","author":"Kanai H","year":"2018","unstructured":"Kanai H, Hagiwara K, Nukaya A, Kondo M, Aso T. Short-term outcome of laparoscopic cholecystectomy for benign gall bladder diseases in 76 dogs. J Vet Med Sci. 2018;80(11):1747-1753. doi:10.1292\/jvms.18-0266"},{"issue":"suppl 1","key":"ref4","series-title":"Vet Surg","first-page":"O156","article-title":"Laparoscopic cholecystectomy with single port access system in 15 dogs","volume":"49","author":"Simon A","year":"2020","unstructured":"Simon A, Monnet E. Laparoscopic cholecystectomy with single port access system in 15 dogs. Vet Surg. 2020;49(suppl 1):O156-O162. doi:10.1111\/vsu.13289"},{"issue":"4","key":"ref5","series-title":"J Small Anim Pract","first-page":"288","article-title":"Laparoscopic cholecystectomy using the subserosal layer dissection technique in dogs: 34 cases (2015-2021)","volume":"64","author":"Kondo M","year":"2023","unstructured":"Kondo M, Hagiwara K, Nukaya A, Aso T, Kanai H. Laparoscopic cholecystectomy using the subserosal layer dissection technique in dogs: 34 cases (2015-2021). J Small Anim Pract. 2023;64(4):288-295. doi:10.1111\/jsap.13577"},{"issue":"11","key":"ref6","series-title":"World J Gastrointest Surg","first-page":"735","article-title":"Impact of laparoscopic surgery training laboratory on surgeon\u2019s performance","volume":"8","author":"Torricelli FCM","year":"2016","unstructured":"Torricelli FCM, Barbosa JABA, Marchini G. Impact of laparoscopic surgery training laboratory on surgeon\u2019s performance. World J Gastrointest Surg. 2016;8(11):735-743. doi:10.4240\/wjgs.v8.i11.735"},{"issue":"2","key":"ref7","series-title":"Surg Laparosc Endosc Percutan Tech","first-page":"180","article-title":"Comparison of 3D imaging and 2D imaging for performance time of laparoscopic cholecystectomy","volume":"23","author":"Bilgen K","year":"2013","unstructured":"Bilgen K, Ust\u00fcn M, Karakahya M, Comparison of 3D imaging and 2D imaging for performance time of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2013;23(2):180-183. doi:10.1097\/SLE.0b013e3182827e17"},{"issue":"5","key":"ref8","series-title":"World J Surg","first-page":"1370","article-title":"Comparative analysis of three-versus two-dimensional imaging in laparoscopic cholecystectomy","volume":"45","author":"Tauriainen A","year":"2021","unstructured":"Tauriainen A, Biancari F, Tauriainen T. Comparative analysis of three-versus two-dimensional imaging in laparoscopic cholecystectomy. World J Surg. 2021;45(5):1370-1375. doi:10.1007\/s00268-020-05934-z"},{"issue":"7","key":"ref9","series-title":"J Laparoendosc Adv Surg Tech A","first-page":"566","article-title":"Three-dimensional versus two-dimensional laparoscopic cholecystectomy: is surgeon experience relevant?","volume":"25","author":"Curr\u00f2 G","year":"2015","unstructured":"Curr\u00f2 G, La Malfa G, Lazzara S, Caizzone A, Fortugno A, Navarra G. Three-dimensional versus two-dimensional laparoscopic cholecystectomy: is surgeon experience relevant? J Laparoendosc Adv Surg Tech A. 2015;25(7):566-570. doi:10.1089\/lap.2014.0641"},{"issue":"1","key":"ref10","series-title":"Pak J Med Sci","first-page":"162","article-title":"Short term outcomes of three dimensional versus two-dimensional laparoscopic cholecystectomy","volume":"37","author":"Shaikh AR","year":"2021","unstructured":"Shaikh AR, Shaikh AA, Abbasi M. Short term outcomes of three dimensional versus two-dimensional laparoscopic cholecystectomy. Pak J Med Sci. 2021;37(1):162-166. doi:10.12669\/pjms.37.1.3721"},{"issue":"4","key":"ref11","series-title":"Vet Surg","first-page":"695","article-title":"Three-dimensional versus two-dimensional laparoscopy for cholecystectomy in a canine cadaveric study","volume":"53","author":"Azuma K","year":"2024","unstructured":"Azuma K, Monnet E. 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Surg Endosc. 2019;33(11):3725-3731. doi:10.1007\/s00464-019-06666-5"},{"issue":"4","key":"ref13","series-title":"Surg Endosc","first-page":"1745","article-title":"3D laparoscopy does not reduce operative duration or errors in day-case laparoscopic cholecystectomy: a randomised controlled trial","volume":"34","author":"Schwab KE","year":"2020","unstructured":"Schwab KE, Curtis NJ, Whyte MB, 3D laparoscopy does not reduce operative duration or errors in day-case laparoscopic cholecystectomy: a randomised controlled trial. Surg Endosc. 2020;34(4):1745-1753. doi:10.1007\/s00464-019-06961-1"},{"issue":"9098","key":"ref14","series-title":"Lancet","first-page":"248","article-title":"Randomised study of influence of two-dimensional versus three-dimensional imaging on performance of laparoscopic cholecystectomy","volume":"351","author":"Hanna GB","year":"1998","unstructured":"Hanna GB, Shimi SM, Cuschieri A. 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Laparoscopic cholecystectomy for management of uncomplicated gall bladder mucocele in six dogs. Vet Surg. 2008;37(7):625-630. doi:10.1111\/j.1532-950X.2008.00428.x"},{"issue":"suppl 1","key":"ref2","series-title":"Vet Surg","first-page":"O49","article-title":"Perioperative complications and outcome of laparoscopic cholecystectomy in 20 dogs","volume":"45","author":"Scott J","year":"2016","unstructured":"Scott J, Singh A, Mayhew PD, Perioperative complications and outcome of laparoscopic cholecystectomy in 20 dogs. Vet Surg. 2016;45(suppl 1):O49-O59. doi:10.1111\/vsu.12534"},{"issue":"11","key":"ref3","series-title":"J Vet Med Sci","first-page":"1747","article-title":"Short-term outcome of laparoscopic cholecystectomy for benign gall bladder diseases in 76 dogs","volume":"80","author":"Kanai H","year":"2018","unstructured":"Kanai H, Hagiwara K, Nukaya A, Kondo M, Aso T. Short-term outcome of laparoscopic cholecystectomy for benign gall bladder diseases in 76 dogs. J Vet Med Sci. 2018;80(11):1747-1753. doi:10.1292\/jvms.18-0266"},{"issue":"suppl 1","key":"ref4","series-title":"Vet Surg","first-page":"O156","article-title":"Laparoscopic cholecystectomy with single port access system in 15 dogs","volume":"49","author":"Simon A","year":"2020","unstructured":"Simon A, Monnet E. Laparoscopic cholecystectomy with single port access system in 15 dogs. Vet Surg. 2020;49(suppl 1):O156-O162. doi:10.1111\/vsu.13289"},{"issue":"4","key":"ref5","series-title":"J Small Anim Pract","first-page":"288","article-title":"Laparoscopic cholecystectomy using the subserosal layer dissection technique in dogs: 34 cases (2015-2021)","volume":"64","author":"Kondo M","year":"2023","unstructured":"Kondo M, Hagiwara K, Nukaya A, Aso T, Kanai H. Laparoscopic cholecystectomy using the subserosal layer dissection technique in dogs: 34 cases (2015-2021). 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Surg Laparosc Endosc Percutan Tech. 2013;23(2):180-183. doi:10.1097\/SLE.0b013e3182827e17"},{"issue":"5","key":"ref8","series-title":"World J Surg","first-page":"1370","article-title":"Comparative analysis of three-versus two-dimensional imaging in laparoscopic cholecystectomy","volume":"45","author":"Tauriainen A","year":"2021","unstructured":"Tauriainen A, Biancari F, Tauriainen T. Comparative analysis of three-versus two-dimensional imaging in laparoscopic cholecystectomy. World J Surg. 2021;45(5):1370-1375. doi:10.1007\/s00268-020-05934-z"},{"issue":"7","key":"ref9","series-title":"J Laparoendosc Adv Surg Tech A","first-page":"566","article-title":"Three-dimensional versus two-dimensional laparoscopic cholecystectomy: is surgeon experience relevant?","volume":"25","author":"Curr\u00f2 G","year":"2015","unstructured":"Curr\u00f2 G, La Malfa G, Lazzara S, Caizzone A, Fortugno A, Navarra G. Three-dimensional versus two-dimensional laparoscopic cholecystectomy: is surgeon experience relevant? J Laparoendosc Adv Surg Tech A. 2015;25(7):566-570. doi:10.1089\/lap.2014.0641"},{"issue":"1","key":"ref10","series-title":"Pak J Med Sci","first-page":"162","article-title":"Short term outcomes of three dimensional versus two-dimensional laparoscopic cholecystectomy","volume":"37","author":"Shaikh AR","year":"2021","unstructured":"Shaikh AR, Shaikh AA, Abbasi M. Short term outcomes of three dimensional versus two-dimensional laparoscopic cholecystectomy. Pak J Med Sci. 2021;37(1):162-166. doi:10.12669\/pjms.37.1.3721"},{"issue":"4","key":"ref11","series-title":"Vet Surg","first-page":"695","article-title":"Three-dimensional versus two-dimensional laparoscopy for cholecystectomy in a canine cadaveric study","volume":"53","author":"Azuma K","year":"2024","unstructured":"Azuma K, Monnet E. 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Surg Endosc. 2019;33(11):3725-3731. doi:10.1007\/s00464-019-06666-5"},{"issue":"4","key":"ref13","series-title":"Surg Endosc","first-page":"1745","article-title":"3D laparoscopy does not reduce operative duration or errors in day-case laparoscopic cholecystectomy: a randomised controlled trial","volume":"34","author":"Schwab KE","year":"2020","unstructured":"Schwab KE, Curtis NJ, Whyte MB, 3D laparoscopy does not reduce operative duration or errors in day-case laparoscopic cholecystectomy: a randomised controlled trial. Surg Endosc. 2020;34(4):1745-1753. doi:10.1007\/s00464-019-06961-1"},{"issue":"9098","key":"ref14","series-title":"Lancet","first-page":"248","article-title":"Randomised study of influence of two-dimensional versus three-dimensional imaging on performance of laparoscopic cholecystectomy","volume":"351","author":"Hanna GB","year":"1998","unstructured":"Hanna GB, Shimi SM, Cuschieri A. 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