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[Positioning systems for endoscopic solo surgery].
Minerva Chir. 2000 Sep; 55(9):635-41.MC

Abstract

BACKGROUND

Endoscopic surgery has acquired undisputed importance in the field of both general and specialised surgery. The introduction of robotic technology in surgery has recently led to the development of new positioning systems for endoscopic surgery. These allow direct control of the endoscopic procedures by the surgeon, whose vision currently depends on the assistant in charge of positioning the optic camera in compliance with his wishes.

METHODS

We experimented different positioning systems for optics and rigid endoscopic instruments for laparoscopy, some of which were our own design. Over 400 cholecystectomies were carried out by six different surgeons on phantoms containing animal organs. The experimental systems were AESOP (Computer Motion, USA), with both foot-pedal and voice control, ENDOASSIST (Armstrong Healthcare Co. UK), controlled by a device worn by the surgeon, FIPS Endoarm (Karlsruhe Research Centre, Germany), controlled by a joystick and voice, and the passive TISKA Endoarm system (Karlsruhe Research Centre, Germany). Combinations of two systems were compared, using one to position the optic and one to position the retractor instrument.

RESULTS

Phantom tests, which are preferable owing to constant conditions, showed the feasibility of experiments in Solo Surgery conditions and highlighted the advantages and drawbacks of the various systems. In particular, the surgeons appreciated the intuitive use of the TISKA Endoarm system as a positioner for the retractor instrument and the optics, in spite of the fact that it was only a passive movement apparatus. Among the remote-control systems tested as an optics positioner, FIPS Endoarm controlled by a joystick was particularly intuitive and produced the best results in terms of time taken to complete the procedure. The time taken was even shorter than that in a large control group with human assistance.

CONCLUSIONS

In our experience endoscopic Solo Surgery was found to be applicable to clinical practice. This will bring numerous advantages in terms of the precision of surgical procedures and savings in terms of time and human resources, with a consequent reduction of management costs. There is no doubt that this method represents a step forward in the application of technology to surgery.

Authors+Show Affiliations

Section for Minimally Invasive Surgery, Department of General Surgery, Eberhard-Karls-University, Tübingen, Germany. alberto.arezzo@uni-tuebingen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

ita

PubMed ID

11155479

Citation

Arezzo, A, et al. "[Positioning Systems for Endoscopic Solo Surgery]." Minerva Chirurgica, vol. 55, no. 9, 2000, pp. 635-41.
Arezzo A, Testa T, Ulmer F, et al. [Positioning systems for endoscopic solo surgery]. Minerva Chir. 2000;55(9):635-41.
Arezzo, A., Testa, T., Ulmer, F., Schurr, M. O., Degregori, M., & Buess, G. F. (2000). [Positioning systems for endoscopic solo surgery]. Minerva Chirurgica, 55(9), 635-41.
Arezzo A, et al. [Positioning Systems for Endoscopic Solo Surgery]. Minerva Chir. 2000;55(9):635-41. PubMed PMID: 11155479.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Positioning systems for endoscopic solo surgery]. AU - Arezzo,A, AU - Testa,T, AU - Ulmer,F, AU - Schurr,M O, AU - Degregori,M, AU - Buess,G F, PY - 2001/1/13/pubmed PY - 2001/4/3/medline PY - 2001/1/13/entrez SP - 635 EP - 41 JF - Minerva chirurgica JO - Minerva Chir VL - 55 IS - 9 N2 - BACKGROUND: Endoscopic surgery has acquired undisputed importance in the field of both general and specialised surgery. The introduction of robotic technology in surgery has recently led to the development of new positioning systems for endoscopic surgery. These allow direct control of the endoscopic procedures by the surgeon, whose vision currently depends on the assistant in charge of positioning the optic camera in compliance with his wishes. METHODS: We experimented different positioning systems for optics and rigid endoscopic instruments for laparoscopy, some of which were our own design. Over 400 cholecystectomies were carried out by six different surgeons on phantoms containing animal organs. The experimental systems were AESOP (Computer Motion, USA), with both foot-pedal and voice control, ENDOASSIST (Armstrong Healthcare Co. UK), controlled by a device worn by the surgeon, FIPS Endoarm (Karlsruhe Research Centre, Germany), controlled by a joystick and voice, and the passive TISKA Endoarm system (Karlsruhe Research Centre, Germany). Combinations of two systems were compared, using one to position the optic and one to position the retractor instrument. RESULTS: Phantom tests, which are preferable owing to constant conditions, showed the feasibility of experiments in Solo Surgery conditions and highlighted the advantages and drawbacks of the various systems. In particular, the surgeons appreciated the intuitive use of the TISKA Endoarm system as a positioner for the retractor instrument and the optics, in spite of the fact that it was only a passive movement apparatus. Among the remote-control systems tested as an optics positioner, FIPS Endoarm controlled by a joystick was particularly intuitive and produced the best results in terms of time taken to complete the procedure. The time taken was even shorter than that in a large control group with human assistance. CONCLUSIONS: In our experience endoscopic Solo Surgery was found to be applicable to clinical practice. This will bring numerous advantages in terms of the precision of surgical procedures and savings in terms of time and human resources, with a consequent reduction of management costs. There is no doubt that this method represents a step forward in the application of technology to surgery. SN - 0026-4733 UR - https://www.unboundmedicine.com/medline/citation/11155479/[Positioning_systems_for_endoscopic_solo_surgery]_ L2 - https://medlineplus.gov/endoscopy.html DB - PRIME DP - Unbound Medicine ER -
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