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First experience with THE AUTOLAP™ SYSTEM: an image-based robotic camera steering device

Abstract

Background

Robotic camera holders for endoscopic surgery have been available for 20 years but market penetration is low. The current camera holders are controlled by voice, joystick, eyeball tracking, or head movements, and this type of steering has proven to be successful but excessive disturbance of surgical workflow has blocked widespread introduction. The Autolap™ system (MST, Israel) uses a radically different steering concept based on image analysis. This may improve acceptance by smooth, interactive, and fast steering. These two studies were conducted to prove safe and efficient performance of the core technology.

Methods

A total of 66 various laparoscopic procedures were performed with the AutoLap™ by nine experienced surgeons, in two multi-center studies; 41 cholecystectomies, 13 fundoplications including hiatal hernia repair, 4 endometriosis surgeries, 2 inguinal hernia repairs, and 6 (bilateral) salpingo-oophorectomies. The use of the AutoLap™ system was evaluated in terms of safety, image stability, setup and procedural time, accuracy of imaged-based movements, and user satisfaction.

Results

Surgical procedures were completed with the AutoLap™ system in 64 cases (97%). The mean overall setup time of the AutoLap™ system was 4 min (04:08 ± 0.10). Procedure times were not prolonged due to the use of the system when compared to literature average. The reported user satisfaction was 3.85 and 3.96 on a scale of 1 to 5 in two studies. More than 90% of the image-based movements were accurate. No system-related adverse events were recorded while using the system.

Conclusion

Safe and efficient use of the core technology of the AutoLap™ system was demonstrated with high image stability and good surgeon satisfaction. The results support further clinical studies that will focus on usability, improved ergonomics and additional image-based features.

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Acknowledgements

The study was sponsored by Medical Surgery Technologies ltd (M.S.T). The company paid the required fees to the ethics committee and all other relevant study-related expenses. No other benefits were received by participating in this study.

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Corresponding author

Correspondence to Paul J. M. Wijsman.

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Disclosures

Paul Wijsman is a Clinical Field Engineer of Medical Surgery Technologies ltd (M.S.T) since 2016. Ivo Broeders, Amir Szold, and Yuval Kaufman are the paid members of the Clinical Advisory Board of M.S.T. Hylke Brenkman, Antonello Forgione, Henk Schreuder, Esther Consten, Werner Draaisma, Paul Verheijen, and Jelle Ruurda have no conflicts of interest or financial ties to disclose.

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Wijsman, P.J.M., Broeders, I.A.M.J., Brenkman, H.J. et al. First experience with THE AUTOLAP™ SYSTEM: an image-based robotic camera steering device. Surg Endosc 32, 2560–2566 (2018). https://doi.org/10.1007/s00464-017-5957-3

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  • DOI: https://doi.org/10.1007/s00464-017-5957-3

Keywords

  • Robotic
  • Steering
  • Camera holder
  • Laparoscopy
  • Active camera control systems
  • Autolap™