Welche Vorteile bringt der Einsatz von 3-D-Kameras in der gynäkologischen Laparoskopie?

Zusammenfassung

Einleitung In der gynäkologischen Chirurgie sind minimalinvasive Operationsmethoden zunehmend auf dem Vormarsch. Die Erweiterung des laparoskopischen OP-Spektrums resultiert u. a. aus einer zunehmenden Verbesserung der Bildgebung. In dieser Arbeit wird untersucht, welche praktischen Vorteile der Einsatz von 3-D-Kameras in der operativen Routine mit sich bringt.

Material und Methoden Es wurden 2 unterschiedliche 3-dimensionale Kamerasysteme mit einem 2-dimensionalen HD-System verglichen. Direkt postoperativ wurden hierzu die Erfahrungen der Operateure mittels Fragebogen erhoben.

Ergebnisse Im Vergleich zum 2-D-Kamerasystem ergaben sich signifikante Vorteile durch die Verwendung von 3-D-Kamerasystemen beim Nähen und Schneiden von Strukturen. Dagegen waren die Vorteile beim Koagulieren nur gering. Die allgemeinen Sichtverhältnisse und insbesondere die Tiefendarstellung des Raumes war durch die Verwendung von 3-D-Kameras signifikant verbessert im Vergleich zum 2-dimensionalen Bild. Dagegen zeigte sich in der Bildbreitendarstellung kein signifikanter Vorteil der stereoskopischen Kameras. Die Darstellung von Adhäsionen und nervalen Strukturen des Retroperitoneums zeigte sich bei 3-D-Kameras signifikant verbessert. Diese Signifikanz war bei Gefäßen, Ureter, Uterus und Ovarien nicht gegeben.

Schlussfolgerung Durch die räumliche Tiefendarstellung ergaben sich besonders signifikante Vorteile gegenüber 2-dimensionalen Kameras bei der Darstellung feiner anatomischer Strukturen. Mit dem Einsatz von 3-D-Kameras wird dem Operateur ein dem realen Situs näheres Monitorbild vermittelt. Daraus resultiert eine Erleichterung des laparoskopischen Operierens.

Schlüsselwörter

Laparoskopie - 3-D - Vorteil - klinischer Nutzen

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