Added value of 3D-vision during robotic pancreatoduodenectomy anastomoses in biotissue (LAEBOT 3D2D): a randomized controlled cross-over trial

Maurice J.W. Zwart; Leia R. Jones; Alberto Balduzzi; Kosei Takagi; Aude Vanlander; Peter B. van den Boezem; Freek Daams; Camiel Rosman; Daan J. Lips; Arthur J. Moser; Melissa E. Hogg; Olivier R.C. Busch; Martijn W.J. Stommel; Marc G. Besselink

doi:10.1007/s00464-020-07732-z

Added value of 3D-vision during robotic pancreatoduodenectomy anastomoses in biotissue (LAEBOT 3D2D): a randomized controlled cross-over trial

Maurice J.W. Zwart, Leia R. Jones, Alberto Balduzzi, Kosei Takagi, Aude Vanlander, Peter B. van den Boezem, Freek Daams, Camiel Rosman, Daan J. Lips, Arthur J. Moser, Melissa E. Hogg, Olivier R.C. Busch, Martijn W.J. Stommel, Marc G. Besselink^*

^*Corresponding author for this work

Surgery

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: We tested the added value of 3D-vision on procedure time and surgical performance during robotic pancreatoduodenectomy anastomoses in biotissue. Robotic surgery has the advantage of articulating instruments and 3D-vision. Consensus is lacking on the added value of 3D-vision during laparoscopic surgery. Given the improved dexterity with robotic surgery, the added value of 3D-vision may be even less with robotic surgery.

Methods: In this experimental randomized controlled cross-over trial, 20 surgeons and surgical residents from 5 countries performed robotic pancreaticojejunostomy and hepaticojejunostomy anastomoses in a biotissue organ model using the da Vinci® system and were randomized to start with either 3D- or 2D-vision. Primary endpoint was the time required to complete both anastomoses. Secondary endpoint was the objective structured assessment of technical skill (OSATS; range 12–60) rating; scored by two observers blinded to 3D/2D.

Results: Robotic 3D-vision reduced the combined operative time from 78.1 to 57.3 min (24.6% reduction, p < 0.001; 20.8 min reduction, 95% confidence intervals 12.8–28.8 min). This reduction was consistent for both anastomoses and between surgeons and residents, p < 0.001. Robotic 3D-vision improved OSATS performance by 6.1 points (20.8% improvement, p = 0.003) compared to 2D (39.4 to 45.1 points, ± 5.5).

Conclusion: 3D-vision has a considerable added value during robotic pancreatoduodenectomy anastomoses in biotissue in both time reduction and improved surgical performance as compared to 2D-vision.

Original language	English
Pages (from-to)	2928-2935
Number of pages	8
Journal	Surgical Endoscopy
Volume	35
Issue number	6
Early online date	13 Jul 2020
DOIs	https://doi.org/10.1007/s00464-020-07732-z
Publication status	Published - Jun 2021

Bibliographical note

For the Dutch Pancreatic Cancer Group

Funding Information:
Mr. Zwart received funding from the Amsterdam UMC for studies on safe implementation of robot-assisted and laparoscopic pancreatic surgery. He also received funding from the Dutch Digestive Foundation (MLDS), for studies on the before mentioned topics. Ms. Jones, Dr. Balduzzi, Dr. Takagi, Dr. Vanlander, Dr. van den Boezem, Dr. Daams, prof. Rosman, Dr. Lips, prof. Moser, prof. Hogg, prof. Busch, Dr. Stommel, and Prof. Besselink have no conflict of interest or financial ties to disclose.

Publisher Copyright:
© 2020, The Author(s).

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Zwart, M. J. W., Jones, L. R., Balduzzi, A., Takagi, K., Vanlander, A., van den Boezem, P. B., Daams, F., Rosman, C., Lips, D. J., Moser, A. J., Hogg, M. E., Busch, O. R. C., Stommel, M. W. J., & Besselink, M. G. (2021). Added value of 3D-vision during robotic pancreatoduodenectomy anastomoses in biotissue (LAEBOT 3D2D): a randomized controlled cross-over trial. Surgical Endoscopy, 35(6), 2928-2935. https://doi.org/10.1007/s00464-020-07732-z

@article{ab95003da26b4966965aeaf69de73ea8,

title = "Added value of 3D-vision during robotic pancreatoduodenectomy anastomoses in biotissue (LAEBOT 3D2D): a randomized controlled cross-over trial",

abstract = "Background: We tested the added value of 3D-vision on procedure time and surgical performance during robotic pancreatoduodenectomy anastomoses in biotissue. Robotic surgery has the advantage of articulating instruments and 3D-vision. Consensus is lacking on the added value of 3D-vision during laparoscopic surgery. Given the improved dexterity with robotic surgery, the added value of 3D-vision may be even less with robotic surgery. Methods: In this experimental randomized controlled cross-over trial, 20 surgeons and surgical residents from 5 countries performed robotic pancreaticojejunostomy and hepaticojejunostomy anastomoses in a biotissue organ model using the da Vinci{\textregistered} system and were randomized to start with either 3D- or 2D-vision. Primary endpoint was the time required to complete both anastomoses. Secondary endpoint was the objective structured assessment of technical skill (OSATS; range 12–60) rating; scored by two observers blinded to 3D/2D. Results: Robotic 3D-vision reduced the combined operative time from 78.1 to 57.3 min (24.6% reduction, p < 0.001; 20.8 min reduction, 95% confidence intervals 12.8–28.8 min). This reduction was consistent for both anastomoses and between surgeons and residents, p < 0.001. Robotic 3D-vision improved OSATS performance by 6.1 points (20.8% improvement, p = 0.003) compared to 2D (39.4 to 45.1 points, ± 5.5). Conclusion: 3D-vision has a considerable added value during robotic pancreatoduodenectomy anastomoses in biotissue in both time reduction and improved surgical performance as compared to 2D-vision.",

author = "Zwart, {Maurice J.W.} and Jones, {Leia R.} and Alberto Balduzzi and Kosei Takagi and Aude Vanlander and {van den Boezem}, {Peter B.} and Freek Daams and Camiel Rosman and Lips, {Daan J.} and Moser, {Arthur J.} and Hogg, {Melissa E.} and Busch, {Olivier R.C.} and Stommel, {Martijn W.J.} and Besselink, {Marc G.}",

note = "For the Dutch Pancreatic Cancer Group Funding Information: Mr. Zwart received funding from the Amsterdam UMC for studies on safe implementation of robot-assisted and laparoscopic pancreatic surgery. He also received funding from the Dutch Digestive Foundation (MLDS), for studies on the before mentioned topics. Ms. Jones, Dr. Balduzzi, Dr. Takagi, Dr. Vanlander, Dr. van den Boezem, Dr. Daams, prof. Rosman, Dr. Lips, prof. Moser, prof. Hogg, prof. Busch, Dr. Stommel, and Prof. Besselink have no conflict of interest or financial ties to disclose. Publisher Copyright: {\textcopyright} 2020, The Author(s).",

year = "2021",

month = jun,

doi = "10.1007/s00464-020-07732-z",

language = "English",

volume = "35",

pages = "2928--2935",

journal = "Surgical Endoscopy",

issn = "0930-2794",

publisher = "Springer New York",

number = "6",

}

Zwart, MJW, Jones, LR, Balduzzi, A, Takagi, K, Vanlander, A, van den Boezem, PB, Daams, F, Rosman, C, Lips, DJ, Moser, AJ, Hogg, ME, Busch, ORC, Stommel, MWJ & Besselink, MG 2021, 'Added value of 3D-vision during robotic pancreatoduodenectomy anastomoses in biotissue (LAEBOT 3D2D): a randomized controlled cross-over trial', Surgical Endoscopy, vol. 35, no. 6, pp. 2928-2935. https://doi.org/10.1007/s00464-020-07732-z

TY - JOUR

T1 - Added value of 3D-vision during robotic pancreatoduodenectomy anastomoses in biotissue (LAEBOT 3D2D)

T2 - a randomized controlled cross-over trial

AU - Zwart, Maurice J.W.

AU - Jones, Leia R.

AU - Balduzzi, Alberto

AU - Takagi, Kosei

AU - Vanlander, Aude

AU - van den Boezem, Peter B.

AU - Daams, Freek

AU - Rosman, Camiel

AU - Lips, Daan J.

AU - Moser, Arthur J.

AU - Hogg, Melissa E.

AU - Busch, Olivier R.C.

AU - Stommel, Martijn W.J.

AU - Besselink, Marc G.

N1 - For the Dutch Pancreatic Cancer Group Funding Information: Mr. Zwart received funding from the Amsterdam UMC for studies on safe implementation of robot-assisted and laparoscopic pancreatic surgery. He also received funding from the Dutch Digestive Foundation (MLDS), for studies on the before mentioned topics. Ms. Jones, Dr. Balduzzi, Dr. Takagi, Dr. Vanlander, Dr. van den Boezem, Dr. Daams, prof. Rosman, Dr. Lips, prof. Moser, prof. Hogg, prof. Busch, Dr. Stommel, and Prof. Besselink have no conflict of interest or financial ties to disclose. Publisher Copyright: © 2020, The Author(s).

PY - 2021/6

Y1 - 2021/6

N2 - Background: We tested the added value of 3D-vision on procedure time and surgical performance during robotic pancreatoduodenectomy anastomoses in biotissue. Robotic surgery has the advantage of articulating instruments and 3D-vision. Consensus is lacking on the added value of 3D-vision during laparoscopic surgery. Given the improved dexterity with robotic surgery, the added value of 3D-vision may be even less with robotic surgery. Methods: In this experimental randomized controlled cross-over trial, 20 surgeons and surgical residents from 5 countries performed robotic pancreaticojejunostomy and hepaticojejunostomy anastomoses in a biotissue organ model using the da Vinci® system and were randomized to start with either 3D- or 2D-vision. Primary endpoint was the time required to complete both anastomoses. Secondary endpoint was the objective structured assessment of technical skill (OSATS; range 12–60) rating; scored by two observers blinded to 3D/2D. Results: Robotic 3D-vision reduced the combined operative time from 78.1 to 57.3 min (24.6% reduction, p < 0.001; 20.8 min reduction, 95% confidence intervals 12.8–28.8 min). This reduction was consistent for both anastomoses and between surgeons and residents, p < 0.001. Robotic 3D-vision improved OSATS performance by 6.1 points (20.8% improvement, p = 0.003) compared to 2D (39.4 to 45.1 points, ± 5.5). Conclusion: 3D-vision has a considerable added value during robotic pancreatoduodenectomy anastomoses in biotissue in both time reduction and improved surgical performance as compared to 2D-vision.

AB - Background: We tested the added value of 3D-vision on procedure time and surgical performance during robotic pancreatoduodenectomy anastomoses in biotissue. Robotic surgery has the advantage of articulating instruments and 3D-vision. Consensus is lacking on the added value of 3D-vision during laparoscopic surgery. Given the improved dexterity with robotic surgery, the added value of 3D-vision may be even less with robotic surgery. Methods: In this experimental randomized controlled cross-over trial, 20 surgeons and surgical residents from 5 countries performed robotic pancreaticojejunostomy and hepaticojejunostomy anastomoses in a biotissue organ model using the da Vinci® system and were randomized to start with either 3D- or 2D-vision. Primary endpoint was the time required to complete both anastomoses. Secondary endpoint was the objective structured assessment of technical skill (OSATS; range 12–60) rating; scored by two observers blinded to 3D/2D. Results: Robotic 3D-vision reduced the combined operative time from 78.1 to 57.3 min (24.6% reduction, p < 0.001; 20.8 min reduction, 95% confidence intervals 12.8–28.8 min). This reduction was consistent for both anastomoses and between surgeons and residents, p < 0.001. Robotic 3D-vision improved OSATS performance by 6.1 points (20.8% improvement, p = 0.003) compared to 2D (39.4 to 45.1 points, ± 5.5). Conclusion: 3D-vision has a considerable added value during robotic pancreatoduodenectomy anastomoses in biotissue in both time reduction and improved surgical performance as compared to 2D-vision.

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U2 - 10.1007/s00464-020-07732-z

DO - 10.1007/s00464-020-07732-z

M3 - Article

C2 - 32661707

AN - SCOPUS:85087824465

SN - 0930-2794

VL - 35

SP - 2928

EP - 2935

JO - Surgical Endoscopy

JF - Surgical Endoscopy

IS - 6

ER -

Added value of 3D-vision during robotic pancreatoduodenectomy anastomoses in biotissue (LAEBOT 3D2D): a randomized controlled cross-over trial

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