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Surgical Endoscopy

, Volume 32, Issue 5, pp 2560–2566 | Cite as

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

  • Paul J. M. Wijsman
  • Ivo A. M. J. Broeders
  • Hylke J. Brenkman
  • Amir Szold
  • Antonello Forgione
  • Henk W. R. Schreuder
  • Esther C. J. Consten
  • Werner A. Draaisma
  • Paul M. Verheijen
  • Jelle P. Ruurda
  • Yuval Kaufman
New Technology

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.

Keywords

Robotic Steering Camera holder Laparoscopy Active camera control systems Autolap™ 

Notes

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.

Compliance with ethical standards

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.

References

  1. 1.
    Dunlap KD, Wanzer L (1998) Is the robotic arm a cost-effective surgical tool? AORN J 68:265–272CrossRefPubMedGoogle Scholar
  2. 2.
    Ballantyne GH (2002) The pitfalls of laparoscopic surgery: challenges for robotics and telerobotic surgery. Surg Laparosc Endosc Percutan Tech 12:1–5.  https://doi.org/10.1097/00129689-200202000-00001 CrossRefPubMedGoogle Scholar
  3. 3.
    Berguer R (1999) Surgery and ergonomics. Arch Surg 134:1011–1016.  https://doi.org/10.1001/archsurg.134.9.1011 CrossRefPubMedGoogle Scholar
  4. 4.
    Hu C-L, Yang C-Y, Lin Z-S, Yang S-Y, Kuo C-H, Lin M-T (2013) An interactive method for achieving ergonomically optimum conditions during laparoscopic surgery. J Robot Surg 7:125–130.  https://doi.org/10.1007/s11701-012-0353-4 CrossRefPubMedGoogle Scholar
  5. 5.
    Miller K, Benden M, Pickens A, Shipp E, Zheng Q (2012) Ergonomics principles associated with laparoscopic surgeon Injury/Illness. Hum Factors J Hum Factors Ergon Soc 54:1087–1092.  https://doi.org/10.1177/0018720812451046 CrossRefGoogle Scholar
  6. 6.
    Van Der Schatte Olivier RH, Van’t Hullenaar CDP, Ruurda JP, Broeders IAMJ (2009) Ergonomics, user comfort, and performance in standard and robot-assisted laparoscopic surgery. Surg Endosc Other Interv Tech 23:1365–1371.  https://doi.org/10.1007/s00464-008-0184-6 CrossRefGoogle Scholar
  7. 7.
    Wagner AA, Varkarakis IM, Link RE, Sullivan W, Su LM (2006) Comparison of surgical performance during laparoscopic radical prostatectomy of two robotic camera holders, EndoAssist and AESOP: a pilot study. Urology 68:70–74.  https://doi.org/10.1016/j.urology.2006.02.003 CrossRefPubMedGoogle Scholar
  8. 8.
    Kommu SS, Rimington P, Anderson C, Rané A (2007) Initial experience with the EndoAssist camera-holding robot in laparoscopic urological surgery. J Robot Surg 1:133–137.  https://doi.org/10.1007/s11701-007-0010-5 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Beckmeier L, Klapdor R, Soergel P, Kundu S, Hillemanns P, Hertel H (2014) Evaluation of active camera control systems in gynecological surgery: construction, handling, comfort, surgeries and results. Arch Gynecol Obstet 289:341–348.  https://doi.org/10.1007/s00404-013-3004-8 CrossRefPubMedGoogle Scholar
  10. 10.
    Maheshwari M, Ind T (2015) Concurrent use of a robotic uterine manipulator and a robotic laparoscope holder to achieve assistant-less solo laparoscopy: the double ViKY. J Robot Surg 9:211–213.  https://doi.org/10.1007/s11701-015-0518-z CrossRefPubMedGoogle Scholar
  11. 11.
    Yong N, Grange P, Eldred-Evans D (2016) Impact of laparoscopic lens contamination in operating theaters: a study on the frequency and duration of lens contamination and commonly utilized techniques to maintain clear vision. Surg Laparosc Endosc Percutan Tech 26:286–289.  https://doi.org/10.1097/SLE.0000000000000289 CrossRefPubMedGoogle Scholar
  12. 12.
    Stolzenburg JU, Franz T, Kallidonis P, Minh D, Dietel A, Hicks J, Nicolaus M, Al-Aown A, Liatsikos E (2011) Comparison of the FreeHand?? Robotic camera holder with human assistants during endoscopic extraperitoneal radical prostatectomy. BJU Int 107:970–974.  https://doi.org/10.1111/j.1464-410X.2010.09656.x CrossRefPubMedGoogle Scholar
  13. 13.
    Aiono S, Gilbert JM, Soin B, Finlay PA, Gordan A (2002) Controlled trial of the introduction of a robotic camera assistant (EndoAssist) for laparoscopic cholecystectomy. Surg Endosc Other Interv Tech 16:1267–1270.  https://doi.org/10.1007/s00464-001-9174-7 CrossRefGoogle Scholar
  14. 14.
    Geis WP, Kim HC, Brennan EJ, McAfee PC, Wang Y (1996) Robotic arm enhancement to accommodate improved efficiency and decreased resource utilization in complex minimally invasive surgical procedures. Stud Health Technol Inform 29:471–481PubMedGoogle Scholar
  15. 15.
    Gillen S, Pletzer B, Heiligensetzer A, Wolf P, Kleeff J, Feussner H, Fürst A (2014) Solo-surgical laparoscopic cholecystectomy with a joystick-guided camera device: a case-control study. Surg Endosc Other Interv Tech 28:164–170.  https://doi.org/10.1007/s00464-013-3142-x CrossRefGoogle Scholar
  16. 16.
    Shushan A, Mohamed H, Magos AL (1999) How long does laparoscopic surgery really take? Lessons learned from 1000 operative laparoscopies. Hum Reprod 14:39–43.  https://doi.org/10.1093/humrep/14.1.39 CrossRefPubMedGoogle Scholar
  17. 17.
    Minutolo V, Licciardello A, Arena M, Nicosia A, Stefano BDI (2014) Laparoscopic cholecystectomy in the treatment of acute cholecystitis: comparison of outcomes and costs between early and delayed cholecystectomy. Eur Rev Med Pharmacol Sci 18:40–46PubMedGoogle Scholar
  18. 18.
    Morino M, Pellegrino L, Giaccone C, Garrone C, Rebecchi F (2006) Randomized clinical trial of robot-assisted versus laparoscopic Nissen fundoplication. Br J Surg 93:553–558.  https://doi.org/10.1002/bjs.5325 CrossRefPubMedGoogle Scholar
  19. 19.
    Keus F, de Jong J, Gooszen HG, Laarhoven CJ (2006) Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev.  https://doi.org/10.1002/14651858.CD006231 Google Scholar
  20. 20.
    Memon MA, Subramanya MS, Hossain MB, Yunus RM, Khan S, Memon B (2015) Laparoscopic anterior versus posterior fundoplication for gastro-esophageal reflux disease: a meta-analysis and systematic review. World J Surg 39:981–996.  https://doi.org/10.1007/s00268-014-2889-0 CrossRefPubMedGoogle Scholar
  21. 21.
    Proske JM, Dagher I, Franco D (2004) Comparative study of human and robotic camera control in laparoscopic biliary and colon surgery. J Laparoendosc Adv Surg Tech A 14:345–348.  https://doi.org/10.1089/lap.2004.14.345 CrossRefPubMedGoogle Scholar
  22. 22.
    Kalteis M, Pistrich R, Schimetta W, Polz W (2007) Laparoscopic cholecystectomy as solo surgery with the aid of a robotic camera holder: a case-control study. Surg Laparosc Endosc Percutan Tech 17:277–282.  https://doi.org/10.1097/SLE.0b013e31806030ae CrossRefPubMedGoogle Scholar
  23. 23.
    Kavoussi LR, Moore RG, Adams JB, Partin AW (1995) Urologists at work comparison of robotic versus human laparoscopic camera control. J Urol 154:2134–2136CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Paul J. M. Wijsman
    • 1
  • Ivo A. M. J. Broeders
    • 1
  • Hylke J. Brenkman
    • 2
  • Amir Szold
    • 3
  • Antonello Forgione
    • 4
  • Henk W. R. Schreuder
    • 5
  • Esther C. J. Consten
    • 1
  • Werner A. Draaisma
    • 1
  • Paul M. Verheijen
    • 1
  • Jelle P. Ruurda
    • 2
  • Yuval Kaufman
    • 6
  1. 1.Deparment of SurgeryMeander Medical CenterAmersfoortThe Netherlands
  2. 2.Department of SurgeryUniversity Medical Center UtrechtUtrechtThe Netherlands
  3. 3.Assia Medical Group, Assuta Medical CenterTel AvivIsrael
  4. 4.Department of SurgeryNiguarda Cà Granda HospitalMilanItaly
  5. 5.Department of Gynecologic OncologyUMC Utrecht Cancer CenterUtrechtThe Netherlands
  6. 6.Department of SurgeryAssuta Medical CenterHaifaIsrael

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