Scope actuation system for articulated laparoscopes.

Autor: Abdurahiman N; Department of Surgery, Hamad Medical Corporation, Doha, Qatar., Khorasani M; Department of Surgery, Hamad Medical Corporation, Doha, Qatar., Padhan J; Department of Surgery, Hamad Medical Corporation, Doha, Qatar., Baez VM; Department of Electrical Engineering, University of Houston, Houston, TX, USA., Al-Ansari A; Department of Surgery, Hamad Medical Corporation, Doha, Qatar., Tsiamyrtzis P; Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy., Becker AT; Department of Electrical Engineering, University of Houston, Houston, TX, USA., Navkar NV; Department of Surgery, Hamad Medical Corporation, Doha, Qatar. nnavkar@hamad.qa.; Department of Surgery, Surgical Research Section, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. nnavkar@hamad.qa.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2023 Mar; Vol. 37 (3), pp. 2404-2413. Date of Electronic Publication: 2023 Feb 07.
DOI: 10.1007/s00464-023-09904-z
Abstrakt: Background: An articulated laparoscope comprises a rigid shaft with an articulated distal end to change the viewing direction. The articulation provides improved navigation of the operating field in confined spaces. Furthermore, incorporation of an actuation system tends to enhance the control of an articulated laparoscope.
Methods: A preliminary prototype of a scope actuation system to maneuver an off-the-shelf articulated laparoscope (EndoCAMaleon by Karl Storz, Germany) was developed. A user study was conducted to evaluate this prototype for the surgical paradigm of video-assisted thoracic surgery. In the study, the subjects maneuvered an articulated scope under two modes of operation: (a) actuated mode where an operating surgeon maneuvers the scope using the developed prototype and (b) manual mode where a surgical assistant directly maneuvers the scope. The actuated mode was further assessed for multiple configurations based on the orientation of the articulated scope at the incision.
Results: The data show the actuated mode scored better than the manual mode on all the measured performance parameters including (a) total duration to visualize a marked region, (a) duration for which scope focus shifts outside a predefined visualization region, and (c) number of times for which scope focus shifts outside a predefined visualization region. Among the different configurations tested using the actuated mode, no significant difference was observed.
Conclusions: The proposed articulated scope actuation system facilitates better navigation of an operative field as compared to a human assistant. Secondly, irrespective of the orientation in which an articulated scope's shaft is inserted through an incision, the proposed actuation system can navigate and visualize the operative field.
(© 2023. The Author(s).)
Databáze: MEDLINE
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