Passage: As in other minimally invasive surgery the first laparoscopic surgeons were smiled at and the surgical community did not believe in this new technology. Today it is the gold standard for most surgeries. Starting with a simple appendectomy, partial kidney resections and partial liver resections, etc. The laparoscopic approach is expanding. The image quality, the possibility of imaging the patient in the surgical position and the guidance of the instruments facilitate this approach.(Efficacy of DynaCT for surgical navigation during complex laparoscopic surgery: an initial experience. Partial resection of the kidney, leaving as much healthy tissue, meaning kidney function to the patient has been described some time ago (Nephron sparing surgery for renal tumors: indications, techniques and outcomes.). The challenges the surgeons face is the loss of natural 3D vision and tactile sensing. Through small ports he/she has to rely on the images provided by the endoscope and is unable to feel the tissue. In a hybrid operating room the anatomy can be updated and imaged in real time. 3D images can be fused and/or overlaid on live fluoroscopy or the endoscope. (Real-time image guidance in laparoscopic liver surgery: first clinical experience with a guidance system based on intraoperative CT imaging.) Crucial anatomy like vessels or a tumor can be avoided and complications reduced. Further investigations are under trial at the moment. (Surgical navigation in urology. European perspective)

Question: What type of vision surgeons lack when operating via endoscope?
3D vision