Converting to High Definition May Improve Operative Stress But Does Not Improve Outcomes

A Gridley, MD, T Kang, MD, J M Bouquoi, RN, W S Richardson, MD. Ochsner Clinic Foundation

Introduction: High definition increases clarity and detail of images compared to the standard laparoscopic equipment. This increased definition of anatomy has the potential to optimize laparoscopic procedures improving outcomes and operating room times.

Aim: Investigate if Operating room times and outcomes were improved with High definition laparoscopic equipment.

Methods: From a prospectively gathered database, we retrospectively compared 100 cases of laparoscopic Roux en-y gastric bypass from before high definition (BHD) to 100 cases after change to high definition equipment (AHD) by a single surgeon. We compared operating room times, age, sex, BMI, and complications between groups. We also compared operating room times after excluding those patients with any previous surgery.

Results: Age, BMI and sex were not significantly different between groups. Mean operating room times were 77.1 minutes BHD and 77.6 minutes AHD with no statistical difference(p=0.737, n=200). After excluding 132 patients with prior surgeries, mean operating room times were 78.0 minutes BHD and 78.8 minutes AHD with no statistical difference (p=0.849,n=68). The overall 30 day complication rate between the two groups was 3(3.1%) and 9 (9.0%) respectively (p=NS). No complications appeared to be a technical consequence of the operative field. No deaths occurred in this study.

Conclusion: Although surgeons subjectively felt improvement in operative stress conversion to high definition did not translate into less operative time or improved outcomes.