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Innovation in surgery/operating room driven by Internet of Things on medical devices

  • 2018 EAES Oral
  • Published:
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Abstract

Background

With the improvement of sensor technology, the trend of Internet of Things (IoT) is affecting the medical devices. The aim of this study is to verify whether it is possible to “visualize instrument usage in specific procedures” by automatically accumulating the digital data related to the behavior of surgical instruments/forceps in laparoscopic surgery.

Methods

Five board-certified surgeons (PGY 9–24 years) performed laparoscopic cholecystectomy on 35-kg porcine (n = 5). Radio frequency identifier (RFID) was attached to each forceps with RFID readers installed on the left/right of the operating table. We automatically recorded the behavior by tracking the operator’s right/left hands’ forceps with RFID. The output sensor was installed in the electrocautery circuit for automatic recordings of the ON/OFF times and the activation time. All data were collected in dedicated software and used for analysis.

Results

In all cases, the behaviors of forceps and electrocautery were successfully recorded. The median operation time was 1828 s (range 1159–2962 s), of which the electrocautery probe was the longest held on the right hand (1179 s, 75%), followed by Maryland dissectors (149 s, 10%), then clip appliers (91 s, 2%). In contrast, grasping forceps were mainly used in the left hand (1780 s, 93%). The activation time of electrocautery was only 8% of the total use and the remaining was mainly used for dissection. These situations were seen in common by all operators, but as a mentor surgeon, there was a tendency to change the right hand’s instruments more frequently. The median activation time of electrocautery was 0.41 s, and these were confirmed to be 0.14–0.57 s among the operators.

Conclusion

By utilization of IoT for surgery, surgical procedure could be “visualized.” This will improve the safety on surgery such as optimal usage of surgical devices, proper use of electrocautery, and standardization of the surgical procedures.

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Authors and Affiliations

  1. Division of Next Generation Endoscopic Intervention (Project ENGINE), Osaka University Graduate School of Medicine, Osaka, Japan

    Yuki Ushimaru & Kiyokazu Nakajima

  2. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

    Yuki Ushimaru, Tsuyoshi Takahashi, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Masaki Mori, Yuichiro Doki & Kiyokazu Nakajima

  3. Department of Gastroenterological Surgery, Kenporen Osaka Central Hospital, Osaka, Japan

    Yoshihito Souma

  4. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan

    Yoshitomo Yanagimoto

  5. Department of Gastroenterological Surgery, Toyonaka Municipal Hospital, Osaka, Japan

    Hirotsugu Nagase

Authors
  1. Yuki Ushimaru
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Corresponding author

Correspondence to Kiyokazu Nakajima.

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Disclosures

Drs. Yuki Ushimaru, Tsuyoshi Takahashi, Yoshihito Souma, Yoshitomo Yanagimoto Hirotsugu Nagase, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Masaki Mori, Yuichiro Doki, and Kiyokazu Nakajima have no conflicts of interest or financial ties to declare.

Ethical approval

All procedures in this study were in accordance with the ethical standards of the responsible committee on institutional human experimentation and with the Helsinki Declaration of 1964 and later versions.

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Ushimaru, Y., Takahashi, T., Souma, Y. et al. Innovation in surgery/operating room driven by Internet of Things on medical devices. Surg Endosc 33, 3469–3477 (2019). https://doi.org/10.1007/s00464-018-06651-4

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  • DOI: https://doi.org/10.1007/s00464-018-06651-4

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