In 2016, a health technology assessment (HTA) was conducted to gather evidence on the safety and overall effectiveness of performing laparoscopic surgery by using 3D videolaparoscopy (3DVL) versus 2D videolaparoscopy (2DVL) display systems in a variety of pediatric surgical procedures in order to efficiently support the final investment decision on video system to be acquired. Results showed that 3DVL might be a good alternative to 2DVL. Moreover, sensitivity analysis has also confirmed that the results associated to the best technology (3DVL) are robust; this has led to a confident decision for recommending it in Bambino Gesù Children's Hospital (OPBG). The objective of this work is to evaluate the impact of 3DVL within the hospital setting after 12 months its introduction in clinical practice.

After 12 months since the technology's introduction, clinical data, identified in previous HTA study, were extracted from surgery registries; data concerning the number of surgeries, duration of intervention, blood loss and surgery complications were analyzed. Statistical analyses on these data, between pre and post 3D system implementation period were carried out.

Results confirmed the 2016 HTA results, highlighting clinical advantages identified a priori. The percentage of the number of laparoscopic procedures significantly increased from 12 percent in pre-3D system installation period to the 20 percent in post 3D system installation (p=7,35E-6). No statistical differences in length of hospital stay, operative time, incidence of perioperative blood loss and surgery complication, between pre- and post- 3D installation period were identified.

This study highlighted the importance of a HTA process before the acquisition of a technology for which the investment decision is not obvious, because benefits and drawbacks of the new technology are unclear. Preliminary results showed that 3D video laparoscopy system seems to be better than the 2D laparoscopy system. However, more data has to be examined to be able to establish the final judgement.