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This is a prospective randomized study involving 80 patients. All participates will be given written information on 3D laparoscopy. They will be randomized according to computer-generated random sequence into two groups, 2D and 3D group. The operation will then be performed either using 2D or 3D laparoscopy. Surgeons are allowed to change to the other type of laparoscopy if difficulty encountered. After the operation, the surgeons will be required to fill in a questionnaire self-evaluating the performance using Global rating scale component of the intraoperative assessment tool (GOALS), any discomfort encountered, any need for change of laparoscopy and their preference on the type of laparoscopy.
The level of complexity of the operation, duration of operation, blood loss and complications will be recorded.
Laparoscopy has greatly replaced laparotomy in most gynaecological operations including oncological procedures. Laparoscopic approach is the mainstay for ovarian cystectomy nowadays. However the loss of depth perception and dexterity remains the drawback of laparoscopy. With the development of robotic surgery, the three-dimension vision and presence of "wrist" motion allowed surgeon to perform more complicated operations in sophisticated manner. Expensive instruments and the need for prolonged time of setup restricted the extensive use of it. Having those considerations in mind, three-dimension (3D) laparoscopy is another possible alternative. With the advancement of technology in 3D vision, it may provide better precision especially in perception of depth and spatial orientation. Dizziness, nausea, headache and ocular fatique are occasional side effects in 3D surgery which created concerns of the surgeons.
There have been studies using standardized tasks shown that 3D laparoscopy will improve the performance in surgeon both objectively and subjectively especially when performing complex task. It was suggested to be able to fasten the learning curve for beginners. The operation time was shorter when laparoscopic cholecystectomy was performed using 3D imaging without any major complications encountered.
Yet evidence in the applicability and use in clinical service in gynaecological operations are still inadequate. The investigators would like to evaluate the difference of 2D versus 3D laparoscopic ovarian cystectomy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| three dimension laparoscopy | Experimental | This group of patients will have laparoscopic ovarian cystectomy performed using three-dimension laparoscopy. The procedure will be performed in usual manner. |
|
| Two dimension laparoscopy | No Intervention | Two-dimension laparosocpy would be used in this group of patient. The procedure will be performed in usual manner. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Three dimension laparoscopy | Device | Surgery will be performed either with three dimension laparoscopy or two dimension laparoscopy. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The Duration of Laparoscopic Ovarian Cystectomy | The duration of laparoscopic ovarian cystectomy will be recorded. It is defined as from insertion of primary port insertion till completion of performance of ovarian cystectomy. The time required for specimen retrieval will not be included. | duration of operation, up to 120 minutes |
| Global Rating Scale Component of the Intraoperative Assessment Tool (GOALS) Score | Surgeons are required to fill in a questionnaire using GOALS. It involved seven aspects - depth perception, bimanual dexterity, efficiency, tissue handling, autonomy, sharpness and image resolution. Each aspects scored 0 to 5 with higher the value, better the performance. The sum of the 7 aspects were used in comparison between groups with a maximum score of 35. | During the operation, up to 120 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Surgeons Encountered Side Effects | Dizziness, nausea and ocular fatique are common side effects of 3D laparoscopy. The number of surgeons experienced discomfort will be reported and any additional discomfort will be recorded. | during the operation, up to 120 minutes |
| Preference of Surgeons |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Man Wa Lui, MBBS | Queen Mary Hospital, The University of Hong Kong | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Obstetrics and Gynaecology, Queen Mary Hospital | Hong Kong | Hong Kong |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22179446 | Background | Storz P, Buess GF, Kunert W, Kirschniak A. 3D HD versus 2D HD: surgical task efficiency in standardised phantom tasks. Surg Endosc. 2012 May;26(5):1454-60. doi: 10.1007/s00464-011-2055-9. Epub 2011 Dec 17. | |
| 24059674 | Background | Lusch A, Bucur PL, Menhadji AD, Okhunov Z, Liss MA, Perez-Lanzac A, McDougall EM, Landman J. Evaluation of the impact of three-dimensional vision on laparoscopic performance. J Endourol. 2014 Feb;28(2):261-6. doi: 10.1089/end.2013.0344. Epub 2014 Jan 10. |
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3 women have been enrolled into the study with informed consent signed. However, their operations were rescheduled, thus did not include in the randomization.
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| ID | Title | Description |
|---|---|---|
| FG000 | Three Dimension Laparoscopy | This group of patients will have laparoscopic ovarian cystectomy performed using three-dimension laparoscopy. The procedure will be performed in usual manner. Three dimension laparoscopy: Surgery will be performed either with three dimension laparoscopy or two dimension laparoscopy. |
| FG001 | Two Dimension Laparoscopy | Two-dimension laparosocpy would be used in this group of patient. The procedure will be performed in usual manner. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Three Dimension Laparoscopy | This group of patients will have laparoscopic ovarian cystectomy performed using three-dimension laparoscopy. The procedure will be performed in usual manner. Three dimension laparoscopy: Surgery will be performed either with three dimension laparoscopy or two dimension laparoscopy. |
| BG001 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | The Duration of Laparoscopic Ovarian Cystectomy | The duration of laparoscopic ovarian cystectomy will be recorded. It is defined as from insertion of primary port insertion till completion of performance of ovarian cystectomy. The time required for specimen retrieval will not be included. | Posted | Mean | Standard Deviation | minutes | duration of operation, up to 120 minutes |
|
2 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Three Dimension Laparoscopy | This group of patients will have laparoscopic ovarian cystectomy performed using three-dimension laparoscopy. The procedure will be performed in usual manner. Three dimension laparoscopy: Surgery will be performed either with three dimension laparoscopy or two dimension laparoscopy. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Manwa Lui | Queen Mary Hospital | 22554647 | ellenlui@hku.hk |
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Surgeons need to indicate their preference of 3D or 2D laparoscopy after the surgery. |
| during the operation, up to 120 minutes |
| Need for Change of Instrument | The surgeons are allowed to switch from 3D laparoscopy to tranditional 2D laparoscopy if deemed necessary by the surgeons. The reason for switch of instrument will be recorded as well. | during the operation, up to 120 minutes |
| Total Blood Loss During Operation | The total amount of blood loss during operation was recorded. | during the operation, up to 120 minutes |
| Duration of Hospital Stay | The total duration of hospital stay was recorded. | Postoperative up to 6 weeks |
| 23072406 | Background | Tanagho YS, Andriole GL, Paradis AG, Madison KM, Sandhu GS, Varela JE, Benway BM. 2D versus 3D visualization: impact on laparoscopic proficiency using the fundamentals of laparoscopic surgery skill set. J Laparoendosc Adv Surg Tech A. 2012 Nov;22(9):865-70. doi: 10.1089/lap.2012.0220. Epub 2012 Oct 16. |
| 22580874 | Background | Wagner OJ, Hagen M, Kurmann A, Horgan S, Candinas D, Vorburger SA. Three-dimensional vision enhances task performance independently of the surgical method. Surg Endosc. 2012 Oct;26(10):2961-8. doi: 10.1007/s00464-012-2295-3. Epub 2012 May 12. |
| 24094658 | Background | Cicione A, Autorino R, Breda A, De Sio M, Damiano R, Fusco F, Greco F, Carvalho-Dias E, Mota P, Nogueira C, Pinho P, Mirone V, Correia-Pinto J, Rassweiler J, Lima E. Three-dimensional vs standard laparoscopy: comparative assessment using a validated program for laparoscopic urologic skills. Urology. 2013 Dec;82(6):1444-50. doi: 10.1016/j.urology.2013.07.047. Epub 2013 Oct 2. |
| 15972181 | Background | Vassiliou MC, Feldman LS, Andrew CG, Bergman S, Leffondre K, Stanbridge D, Fried GM. A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg. 2005 Jul;190(1):107-13. doi: 10.1016/j.amjsurg.2005.04.004. |
| 23579515 | Result | Bilgen K, Ustun M, Karakahya M, Isik S, Sengul S, Cetinkunar S, Kucukpinar TH. Comparison of 3D imaging and 2D imaging for performance time of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2013 Apr;23(2):180-3. doi: 10.1097/SLE.0b013e3182827e17. |
| Two Dimension Laparoscopy |
Two-dimension laparosocpy would be used in this group of patient. The procedure will be performed in usual manner. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| body mass index | Mean | Standard Deviation | kg/m2 |
|
Two-dimension laparosocpy would be used in this group of patient. The procedure will be performed in usual manner.
|
|
|
| Primary | Global Rating Scale Component of the Intraoperative Assessment Tool (GOALS) Score | Surgeons are required to fill in a questionnaire using GOALS. It involved seven aspects - depth perception, bimanual dexterity, efficiency, tissue handling, autonomy, sharpness and image resolution. Each aspects scored 0 to 5 with higher the value, better the performance. The sum of the 7 aspects were used in comparison between groups with a maximum score of 35. | Chief surgeons of the operation were required to find in a questionnaire immediate postoperatively which include GOALS score assessment, any side effects experienced and their preferences for 2D/ 3D laparoscopy for the particular operation. As the assessment is on case to case basis, thus individual surgeons not recruited. | Posted | Mean | Standard Deviation | score on a scale | During the operation, up to 120 minutes |
|
|
|
|
| Secondary | Number of Surgeons Encountered Side Effects | Dizziness, nausea and ocular fatique are common side effects of 3D laparoscopy. The number of surgeons experienced discomfort will be reported and any additional discomfort will be recorded. | Chief surgeons of the operation were required to find in a questionnaire immediate postoperatively which include GOALS score assessment, any side effects experienced and their preferences for 2D/ 3D laparoscopy for the particular operation. As the assessment is on case to case basis, thus individual surgeons not recruited. | Posted | Count of Participants | Participants | during the operation, up to 120 minutes |
|
|
|
| Secondary | Preference of Surgeons | Surgeons need to indicate their preference of 3D or 2D laparoscopy after the surgery. | Chief surgeons of the operation were required to find in a questionnaire immediate postoperatively which include GOALS score assessment, any side effects experienced and their preferences for 2D/ 3D laparoscopy for the particular operation. As the assessment is on case to case basis, thus individual surgeons not recruited. | Posted | Count of Participants | Participants | during the operation, up to 120 minutes |
|
|
|
| Secondary | Need for Change of Instrument | The surgeons are allowed to switch from 3D laparoscopy to tranditional 2D laparoscopy if deemed necessary by the surgeons. The reason for switch of instrument will be recorded as well. | Posted | Count of Participants | Participants | during the operation, up to 120 minutes |
|
|
|
| Secondary | Total Blood Loss During Operation | The total amount of blood loss during operation was recorded. | Chief surgeons of the operation were required to find in a questionnaire immediate postoperatively which include GOALS score assessment, any side effects experienced and their preferences for 2D/ 3D laparoscopy for the particular operation. As the assessment is on case to case basis, thus individual surgeons not recruited. | Posted | Mean | Standard Deviation | ml | during the operation, up to 120 minutes |
|
|
|
| Secondary | Duration of Hospital Stay | The total duration of hospital stay was recorded. | Chief surgeons of the operation were required to find in a questionnaire immediate postoperatively which include GOALS score assessment, any side effects experienced and their preferences for 2D/ 3D laparoscopy for the particular operation. As the assessment is on case to case basis, thus individual surgeons not recruited. | Posted | Mean | Standard Deviation | Days | Postoperative up to 6 weeks |
|
|
|
| 0 |
| 37 |
| 0 |
| 37 |
| 0 |
| 37 |
| EG001 | Two Dimension Laparoscopy | Two-dimension laparosocpy would be used in this group of patient. The procedure will be performed in usual manner. | 0 | 38 | 0 | 38 | 0 | 38 |
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| No Preference |
|