Impact of 3D high-definition laparoscopy on total laparoscopic hysterectomy: a body mass index-stratified retrospective analysis

BACKGROUND: Three-dimensional (3D) high-definition (HD) laparoscopy is a promising tool in minimally invasive gynecologic surgery, offering enhanced depth perception and visualization. However, its role in total laparoscopic hysterectomy (TLH), particularly in patients with varying body mass index (...

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Main Authors: Smit Bharat Solanki, Vineet V. Mishra, Arminder Singh Dhiman
Format: Article
Language:English
Published: King Faisal Specialist Hospital and Research Centre 2025-07-01
Series:Annals of Saudi Medicine
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Online Access:http://www.annsaudimed.net/doi/10.5144/0256-4947.2025.243
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author Smit Bharat Solanki
Vineet V. Mishra
Arminder Singh Dhiman
author_facet Smit Bharat Solanki
Vineet V. Mishra
Arminder Singh Dhiman
author_sort Smit Bharat Solanki
collection DOAJ
description BACKGROUND: Three-dimensional (3D) high-definition (HD) laparoscopy is a promising tool in minimally invasive gynecologic surgery, offering enhanced depth perception and visualization. However, its role in total laparoscopic hysterectomy (TLH), particularly in patients with varying body mass index (BMI), remains underexplored. OBJECTIVE: To evaluate the impact of 3D HD laparoscopy on surgical efficiency and patient outcomes in TLH, with a focus on BMI-related differences. DESIGN AND SETTINGS: A single-center retrospective study PATIENTS AND METHODS: Sixty patients who underwent TLH were included: n=30 used 3D HD laparoscopy (Aesculap 3D EinsteinVision) and n=30 matched controls used 2D laparoscopy. Matching criteria included uterine weight and prior surgical history. Patients were stratified according to BMI (≤24.9, 25–29.9, ≥30.0 kg/m2). MAIN OUTCOME MEASURES: Operative time, vault suturing time, blood loss, trocar site incisions, haemoglobin drop, and complication rates. SAMPLE SIZE: 60 patients (30 in each group) RESULTS: The 3D HD laparoscopy group demonstrated significant improvements across multiple outcomes. Trocar site incisions were significantly reduced in all BMI categories (P <.001). Vault suturing time was shorter in the 3D HD laparoscopy group (P =.002), and total operative time was reduced in overweight patients (P =.015). Obese patients in the 3D group had lower haemoglobin drop (P =.01) and reduced blood loss compared to 2D laparoscopy group (P =.017). CONCLUSION: 3D HD laparoscopy enhances surgical efficiency in TLH, especially in patients with higher BMI, by minimizing trocar site incisions, reducing vault suturing times, and improving hemostasis—highlighting its value in overcoming challenges of minimally invasive gynecologic surgery. LIMITATIONS: The study's retrospective design and modest sample size limit generalizability.
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spelling doaj-art-00396c6de9fb43b899c784be1c31c5702025-08-20T03:45:08ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662025-07-0145424324810.5144/0256-4947.2025.243Impact of 3D high-definition laparoscopy on total laparoscopic hysterectomy: a body mass index-stratified retrospective analysisSmit Bharat Solanki0Vineet V. Mishra1Arminder Singh Dhiman2From the Department of Obstetrics and Gynecology, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, IndiaFrom the Department of Obstetrics and Gynecology, Apollo Hospitals Ahmedabad, Gandhinagar, IndiaFrom the Department of Sales, B Braun Medical India Pvt Ltd, Mumbai, IndiaBACKGROUND: Three-dimensional (3D) high-definition (HD) laparoscopy is a promising tool in minimally invasive gynecologic surgery, offering enhanced depth perception and visualization. However, its role in total laparoscopic hysterectomy (TLH), particularly in patients with varying body mass index (BMI), remains underexplored. OBJECTIVE: To evaluate the impact of 3D HD laparoscopy on surgical efficiency and patient outcomes in TLH, with a focus on BMI-related differences. DESIGN AND SETTINGS: A single-center retrospective study PATIENTS AND METHODS: Sixty patients who underwent TLH were included: n=30 used 3D HD laparoscopy (Aesculap 3D EinsteinVision) and n=30 matched controls used 2D laparoscopy. Matching criteria included uterine weight and prior surgical history. Patients were stratified according to BMI (≤24.9, 25–29.9, ≥30.0 kg/m2). MAIN OUTCOME MEASURES: Operative time, vault suturing time, blood loss, trocar site incisions, haemoglobin drop, and complication rates. SAMPLE SIZE: 60 patients (30 in each group) RESULTS: The 3D HD laparoscopy group demonstrated significant improvements across multiple outcomes. Trocar site incisions were significantly reduced in all BMI categories (P <.001). Vault suturing time was shorter in the 3D HD laparoscopy group (P =.002), and total operative time was reduced in overweight patients (P =.015). Obese patients in the 3D group had lower haemoglobin drop (P =.01) and reduced blood loss compared to 2D laparoscopy group (P =.017). CONCLUSION: 3D HD laparoscopy enhances surgical efficiency in TLH, especially in patients with higher BMI, by minimizing trocar site incisions, reducing vault suturing times, and improving hemostasis—highlighting its value in overcoming challenges of minimally invasive gynecologic surgery. LIMITATIONS: The study's retrospective design and modest sample size limit generalizability.http://www.annsaudimed.net/doi/10.5144/0256-4947.2025.2433D HD LaparoscopyMinimally Invasive GynecologySurgical Outcomes OptimizationObesity in Laparoscopy
spellingShingle Smit Bharat Solanki
Vineet V. Mishra
Arminder Singh Dhiman
Impact of 3D high-definition laparoscopy on total laparoscopic hysterectomy: a body mass index-stratified retrospective analysis
Annals of Saudi Medicine
3D HD Laparoscopy
Minimally Invasive Gynecology
Surgical Outcomes Optimization
Obesity in Laparoscopy
title Impact of 3D high-definition laparoscopy on total laparoscopic hysterectomy: a body mass index-stratified retrospective analysis
title_full Impact of 3D high-definition laparoscopy on total laparoscopic hysterectomy: a body mass index-stratified retrospective analysis
title_fullStr Impact of 3D high-definition laparoscopy on total laparoscopic hysterectomy: a body mass index-stratified retrospective analysis
title_full_unstemmed Impact of 3D high-definition laparoscopy on total laparoscopic hysterectomy: a body mass index-stratified retrospective analysis
title_short Impact of 3D high-definition laparoscopy on total laparoscopic hysterectomy: a body mass index-stratified retrospective analysis
title_sort impact of 3d high definition laparoscopy on total laparoscopic hysterectomy a body mass index stratified retrospective analysis
topic 3D HD Laparoscopy
Minimally Invasive Gynecology
Surgical Outcomes Optimization
Obesity in Laparoscopy
url http://www.annsaudimed.net/doi/10.5144/0256-4947.2025.243
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