Abstract
Purpose
Endoscopic surgery is performed under a horizontal view in comparison to the vertical view that is associated with open surgery. We developed an endoscopic pseudo-viewpoint alternation system with out any scope action. We investigate the effect of this novel system on forceps manipulation among expert pediatric surgeons.
Methods
Six expert pediatric surgeons performed a Nissen wrap in a fundoplication simulator either with or without this system. The constructed Nissen wrap was evaluated. The total path length and the average velocity of the forceps were also analyzed.
Results
The times required either with or without this system were 587.5 ± 122.7 and 634.0 ± 212.4 s (p = 0.45), respectively. The total path lengths of right and left forceps either with or without this system were 12,309 ± 2495.5 and 15,726 ± 5649.6 mm (p = 0.07), 10,091 ± 2439.2 and 12,575 ± 5511.1 mm (p = 0.11), respectively. The average velocity of the right and left forceps with or without this system were 26.9 ± 5.29 and 31.6 ± 1.62 mm/s (p = 0.04), 21.6 ± 2.48 and 25.5 ± 6.48 mm/s (p = 0.15), respectively. There was no significance in the suture balance and suture interval.
Conclusion
The endoscopic pseudo-viewpoint alternation system thus made it possible for expert pediatric surgeons to carry out slow and economical forceps manipulation. These effects make it possible for surgeons to perform safe and precise surgery, thus leading to a shortening of operation time.
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Acknowledgments
We thank Brian Quinn for his comments and help with the manuscript. This study was supported by Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS, No.25293360, and No. 26670765), JFE (The Japanese Foundation for Research and Promotion of Endoscopy) and J-CASE (Japanese Consortium of Advanced Surgical Endoscopy).
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Ieiri, S., Jimbo, T., Koreeda, Y. et al. The effect of forceps manipulation for expert pediatric surgeons using an endoscopic pseudo-viewpoint alternating system: the phenomenon of economical slow and fast performance in endoscopic surgery. Pediatr Surg Int 31, 971–976 (2015). https://doi.org/10.1007/s00383-015-3777-x
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DOI: https://doi.org/10.1007/s00383-015-3777-x