Advertisement

Archives of Gynecology and Obstetrics

, Volume 289, Issue 2, pp 341–348 | Cite as

Evaluation of active camera control systems in gynecological surgery: construction, handling, comfort, surgeries and results

  • Luisa Beckmeier
  • Rüdiger Klapdor
  • Phillip Soergel
  • Sudip Kundu
  • Peter Hillemanns
  • Hermann Hertel
General Gynecology

Abstract

Objective

Surgeon-controlled endoscope leading assistance systems are a novelty in endoscopic surgery. These systems were evaluated for their applicability and reliability in operative gynecology. In this regard, we evaluated possible methods of operation, operative time, setup time, and comfort for the surgeon, complications, blood transfusions, length of stay, hemoglobin levels, and demographic data.

Methods

Two systems with technically identical camera control systems were applied, the SOLOASSIST™ system and the Einstein Vision™ 3D system. The arm systems are attached to the operating table and controlled by surgeon via a manual control, a remote control or a foot switch. Comfort for the surgeon was evaluated using a questionnaire (scale 1–5; 1 “very good”, 5 “poor”). All data were collected prospectively in a database (IBM SPSS Statistics 20) and evaluated.

Results

One hundred and four patients underwent surgery supported by an active control system. In 43 (41 %) cases, oncological interventions were performed. Average setup time was 7 (3–30) min. There was a significant learning curve regarding the mounting of the system after 20 operations (p = 0.045). Overall comfort was rated as “good”, divided into control 2.2 (2–4), physical effort 2.1 (1–4), picture quality 1.6 (1–3), and overall satisfaction 2.1 (1–4). About 75 unwanted camera movements were noticed in 104 surgeries. Complications occurred in no case (0 %).

Conclusion

The application of an active camera control system was evaluated to be safe for all gynecological laparoscopies. Picture blur is avoided even during prolonged complex procedures. Moreover, the assistant is able to support the surgeon with two instruments, with the result that the presence of a second assistant is not required for complex interventions. Causing only minimal setup time, the examined active control systems improve the effectiveness of surgeries. The physical effort required for the assistant decreases and, by reducing tiring operations and tremor, subsequently, higher precision is reached.

Keywords

Laparoscopy Active camera control systems SOLOASSIST™ Einstein Vision™ 3D surgery 

Notes

Conflict of interest

None.

References

  1. 1.
    Palep JH (2009) Robotic assisted minimally invasive surgery. J Minim Access Surg. 5(1):1–7PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Weinberg L, Rao S, Escobar PF (2011) Robotic surgery in gynecology: an updated systematic review. Obstet Gynecol Int Epub: 852061Google Scholar
  3. 3.
    Tinelli A, Malvasi A, Gustapane S, Buscarini M, Gill IS, Stark M, Nezhat FR, Mettler L (2011) Robotic assisted surgery in gynecology: current insights and future perspectives. Recent Pat Biotechnol 5(1):12–24PubMedCrossRefGoogle Scholar
  4. 4.
    Kristin J, Geiger R, Knapp FB, Schipper J, Klenzner T (2011) Use of a mechatronic robotic camera holding system in head and neck surgery. HNO 59(6):575–581PubMedCrossRefGoogle Scholar
  5. 5.
    Arezzo A, Testa T, Ulmer F, Schurr MO, Degregori M, Buess GF (2000) Positioning systems for endoscopic solo surgery. Minerva Chir 55(9):635–641PubMedGoogle Scholar
  6. 6.
    Gilbert JM (2009) The EndoAssist robotic camera holder as an aid to the introduction of laparoscopic colorectal surgery. Ann R Coll Surg Engl 91(5):389–393 Epub 2009 Apr 30PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Bogess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN, Fowler WC (2008) A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J Obstet Gynecol 199:360.e1–9Google Scholar
  8. 8.
    Bell MC, Torgerson J, Seshadri-Kreaden U, Suttle AW, Hunt S (2008) Comparison of outcomes and cost for endometrial cancer staging via traditional laparotomy, standard laparoscopy and robotic techniques. Gynecol Oncol 111(3):407–411PubMedCrossRefGoogle Scholar
  9. 9.
    Payne TN, Dauterive FR (2008) A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. J Minim Invasive Gynecol 15(3):286–291PubMedCrossRefGoogle Scholar
  10. 10.
    Hellan M, Anderson C, Ellenhorn JD, Paz B, Pigazzi A (2007) Short-term outcomes after robotic-assisted total mesorectal excision for rectal cancer. Ann Surg Oncol 14(11):3168–3173PubMedCrossRefGoogle Scholar
  11. 11.
    Nix J, Smith A, Kurpad R, Nielsen ME, Wallen EM, Pruthi RS (2010) Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results. Eur Urol 57(2):196–201. doi: 10.1016/j.eururo.2009.10.024 PubMedCrossRefGoogle Scholar
  12. 12.
    DeNardis SA, Holloway RW, Bigsby GE, Pikaart DP, Ahmad S, Finkler NJ (2008) Robotically assisted laparoscopic hysterectomy versus total abdominal hysterectomy and lymphadenectomy for endometrial cancer. Gynecol Oncol 111(3):412–417. doi: 10.1016/j.ygyno.2008.08.025 PubMedCrossRefGoogle Scholar
  13. 13.
    Lambaudie E, Narducci F, Bannier M, Jauffret C, Pouget N, Leblanc E, Houvenaeghel G (2010) Role of robot-assisted laparoscopy in adjuvant surgery for locally advanced cervical cancer. Eur J Surg Oncol 36(4):409–413. doi: 10.1016/j.ejso.2009.12.004 PubMedCrossRefGoogle Scholar
  14. 14.
    Magrina JF, Kho R, Magtibay PM (2009) Robotic radical hysterectomy: technical aspects. Gynecol Oncol 113(1):28–31. doi: 10.1016/j.ygyno.2008.12.031 PubMedCrossRefGoogle Scholar
  15. 15.
    Boggess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN, Fowler WC (2008) A case-control study of robot-assisted type III radical hysterectomy with pelvic lymph node dissection compared with open radical hysterectomy. Am J Obstet Gynecol 199(4):357.e1–7. doi: 10.1016/j.ajog.2008.06.058 PubMedGoogle Scholar
  16. 16.
    Kim YT, Kim SW, Hyung WJ, Lee SJ, Nam EJ, Lee WJ (2008) Robotic radical hysterectomy with pelvic lymphadenectomy for cervical carcinoma: a pilot study. Gynecol Oncol 108(2):312–316PubMedCrossRefGoogle Scholar
  17. 17.
    Nezhat C, Saberi NS, Shahmohamady B, Nezhat F (2006) Robotic-assisted laparoscopy in gynecological surgery. JSLS 10(3):317–320PubMedPubMedCentralGoogle Scholar
  18. 18.
    Sarlos D, Kots L, Stevanovic N, Schaer G (2010) Robotic hysterectomy versus conventional laparoscopic hysterectomy: outcome and cost analyses of a matched case-control study. Eur J Obstet Gynecol Reprod Biol 150(1):92–96PubMedCrossRefGoogle Scholar
  19. 19.
    Breitenstein S, Nocito A, Puhan M, Held U, Weber M, Clavien PA (2008) Robotic-assisted versus laparoscopic cholecystectomy: outcome and cost analyses of a case-matched control study. Ann Surg 247(6):987–993PubMedCrossRefGoogle Scholar
  20. 20.
    Veljovich DS, Paley PJ, Drescher CW, Everett EN, Shah C, Peters WA (2008) Robotic surgery in gynecologic oncology: program initiation and outcomes after the first year with comparison with laparotomy for endometrial cancer staging. Am J Obstet Gynecol 198(6):679.e1–9 discussion 679.e9–10CrossRefGoogle Scholar
  21. 21.
    Corronado PJ, Herraiz MA, Magrina JF, Fasero M, Vidart JA (2012) Comparison of perioperative outcomes and cost of robotic-assisted laparoscopy, laparoscopy and laparotomy for endometrial cancer. Eur J Obstet Gynecol Epub: http://dx.doi.org/10.1016/j.ejogrb.2012.07.006
  22. 22.
    Magrina JF, Kho RM, Weaver AL, Montero RP, Magtibay PM (2008) Robotic radical hysterectomy: comparison with laparoscopy and laparotomy. Gynecol Oncol 109(1):86–91. doi: 10.1016/j.ygyno.2008.01.011 PubMedCrossRefGoogle Scholar
  23. 23.
    Nezhat FR, Datta S, Liu C, Chuang L, Zakashansky K (2008) Robotic radical hysterectomy versus total laparoscopic radical hysterectomy with pelvic lymphadenectomy for treatment of early cervical cancer. JSLS 12(3):227–237PubMedPubMedCentralGoogle Scholar
  24. 24.
    Taylor SE, McBee WC Jr, Richard SD, Edwards RP (2011) Radical hysterectomy for early stage cervical cancer: laparoscopy versus laparotomy. JSLS 15(2):213–217. doi: 10.4293/108680811X13022985132218 PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Luisa Beckmeier
    • 1
  • Rüdiger Klapdor
    • 1
  • Phillip Soergel
    • 1
  • Sudip Kundu
    • 1
  • Peter Hillemanns
    • 1
  • Hermann Hertel
    • 1
  1. 1.Department for Obstetrics and GynecologyMedical School HannoverHannoverGermany

Personalised recommendations