Appendiceal Abscess, Appendicitis, Appendicitis Acute, Appendicitis Peritonitis, Appendicitis With Perforation, Appendicolith
Conditions
Keywords
3d Laparoscopy
Brief summary
Laparoscopy has revolutionized the approach to a number of surgical problems causing a re-evaluation of several clinical strategies. Now it has become the standard treatment for majority of ailments including symptomatic gall stone disease, appendicitis, GERD (gastroesophageal reflux disease), morbid obesity and colorectal disease. All these developments aim at minimizing perioperative morbidities, providing rapid postoperative recovery and enhancing patient's safety profile. One of the major limitations of conventional laparoscopy is lack of depth perception. Introduction of 3D imaging, has removed many of these technical obstacles. In 1993, Becker et al., reported that a 3D display might improve laparoscopic skills. Since then, many researchers have demonstrated benefit of 3D imaging . Starting from this, we can theorize an impact of 3D technologies on surgeon's learning curves. This concern is recently being demonstrated in experimental and clinical setting with improvement of hand-eye coordination, better laparoscopic skills and less time to learn surgical procedure. Usually junior surgeons (JS) start their activities with cholecystectomy and appendectomy but, despite an amount of literature regarding the first procedure, there is a 'black hole' regarding the use of 3D imaging in laparoscopic appendectomy (LA). The investigators decided to investigate the impact of 3D visualization on surgeons' and surgical outcome during laparoscopic appendectomy (LA) performed by junior surgeons (JS). Operative details and clinical aspect are both take in account in order to looking for any advantages or concerns conferred on JS in performing LA.
Interventions
PROCEDURE3D Laparoscopic Appendectomy
surgical removal of inflamed cecal appendix by 3D laparoscopic procedure
PROCEDURE2D Laparoscopic Appendectomy
surgical removal of inflamed cecal appendix by 2D laparoscopic procedure
Sponsors
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* All adult patients scheduled to undergo laparoscopic appendectomy. Ages eligible for study: \>18 Sexes eligible for study: All
Exclusion criteria
* Patients who decline to join the study * Patients under 18 years old * Patients with contraindication to undergo laparoscopic surgery. * Patients without appendicular disease found at laparoscopy (such as complicated inflammatory bowel disease, tumor, complicated diverticula, gynecological disorder) * Patients undergoing open appendectomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Operative time. | 1 minute after surgery | Time taken for the completion of the procedure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Conversion to open appendectomy. | 1 minute after surgery | Compare the rate of conversion between each arm. |
| Intraoperative complication | 1 minute after surgery | Accidental bowel or bladder perforation, uncontrolled bleeding. |
| Post-operative complication. morbidity, readmission at 30th days, mortality | 30 days | Post-operative complication. morbidity, readmission at 30th days, mortality |
| Surgeon's comfort | 1 hour after surgery | based on questionnaire following the operation: LIKERT scale: from 1 to 5 points for 8 items divided in 2 evaluation: surgical outcome and surgical strain. Surgical outcome: item 1: surgical skill perception item 2: definition of surgical field item 3: deep perception Surgical strain: item1: hand and wrist strain item 2: neck strain item 3: back strain item 4: eye strain item 5: performance anxiety |
Countries
Italy
Outcome results
None listed