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Surgical Endoscopy

Published in:

01-04-2005 | Original article

Experimental assessment of a new mechanical endoscopic solosurgery system: Endofreeze

Authors: A. Arezzo, M. O. Schurr, A. Braun, G. F. Buess

Published in: Surgical Endoscopy | Issue 4/2005

Abstract

Background

The assistance received by the surgeon from support personnel during operative laparoscopy is extremely important. This includes retraction of instruments and endoscope positioning. However, human assistance is costly and often does not provide satisfaction for the surgeon. The aim of this study was to develop a mechanical arm capable of allowing easy handling and holding of laparoscopic instruments under the surgeon’s control.

Methods

We designed a system, named Endofreeze, based on a particular kinematical construction that maintains an invariant point of constraint motion just above the trocar puncture site through the abdominal wall. The goal was to develop this way a highly intuitive mechanical holding system for laparoscopic instruments, with sufficient precision of action, activated by a single hand movement. We tested a couple of prototypes with different holding arms while performing cholecystectomy in phantom models with swine inserts and compared the results obtained in similar conditions using different holding and positioning systems.

Results

The system allows transparent and intuitive operation, and its setup is easy and quick. It may be adapted either as an instrument retractor or as an optic positioning device. Compared to different systems available or prototypes previously tested, such as AESOP 2000, ENDOASSIST, FIPS Endoarm, TISKA Endoarm, and the Martin Arm, in similar conditions, it was more intuitive, allowing shorter time for completion of surgery.

Conclusion

Endofreeze is a new intuitive mechanical positioning system for endoscopic solo surgery. In phantom models, it demonstrated a shorter time requirement for completion of surgery when compared to other systems available. In our opinion, it represents a valid compromise between human and robotic control for conventional laparoscopic instruments.

Arezzo, A, Ulmer, F, Weiss, O, Schurr, MO, Hamad, M, Buess, GF 2000Experimental trial on solo surgery for minimally invasive therapy: comparison of different systems in a phantom modelSurgl Endosc14955959CrossRef

Benabid, AL, Lavallee, S, Hoffmann, D, Cinquin, P, Demongeot, J, Danel, F 1992Potential use of robots in endoscopic neurosurgeryActa Neurochir Suppl549397

Buess, GF, Arezzo, A, Schurr, MO, Ulmer, F, Fischer, H, Gumb, L, Testa, T, Nobman, C 2000A new remote-controlled endoscope positioning system for endoscopic solo surgerySurg Endosc14395399CrossRefPubMed

Davies, BL, Hibberd, RD, Coptcoat, MJ, Wickham, JE 1989A surgeon robot prostatectomy-a laboratory evaluationJ Med Eng Technol13273277PubMed

Finlay, PA, Ornstein, MH 1995Controlling the movement of a surgical laparoscopeIEEE Eng Med Biol14289291CrossRef

Glantz, SA 1996Primer of Biostatistics, Version 4.0McGraw-HillNew York

Kelly, PJ, Kail, BA, Goerss, S, Earnest, F 1986Computer assisted stereotactic laser resection of intra-axial brain neoplasmJ Neurosurg64427439PubMed

Koyama, H, Uchida, T, Funakubo, H, Takakura, K, Fankhauser, H 1990Development of a new microsurgical robot for stereotactic neurosurgeryStereotact Funct Neurosurg54-55462467PubMed

Matsen, FA, Garbini, JL, Sidles, JA, Pratt, B, Baumgarten, D, Kaiura, R 1993Robotic assistance in orthopaedic surgery. A proof of principle using distal femoral arthroplastyClin Orthop296178186PubMed

10.

Mueglitz, J, Kunad, , Dautzenberg, P, Neisius, B, Trapp, R 1993Kinematic problems of manipulators in minimally invasive surgeryEndosc Surg Allied Technol1160164PubMed

11.

Sackier, JM, Wang, Y 1994Robotically assisted laparoscopic surgery. From concept to developmentSurg Endosc86366PubMed

12.

Schurr, MO, Arezzo, A, Neisius, B, Rininsland, HH, Hilzinger, HU, Dorn, J, Roth, K, Buess, GF 1999Trocar and instrument positioning system TISKA: an assist device for endoscopic solo-surgerySurg Endosc13528531CrossRefPubMed

13.

Taylor, KS 1993Robodoc: study tests robot’s use in hip surgeryHospitals6746

14.

Traverse, LW, Koo, KP, Hargrave, K, et al. 1997Standardizing laparoscopic procedure time and determining the effect of patient age/gender or absence of surgical residents during operationsSurg Endosc11226229CrossRefPubMed

Title: Experimental assessment of a new mechanical endoscopic solosurgery system: Endofreeze
Authors: A. Arezzo
M. O. Schurr
A. Braun
G. F. Buess
Publication date: 01-04-2005
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 4/2005
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-003-9132-7

At a glance: The STEP trials

Springer Medicine

Experimental assessment of a new mechanical endoscopic solosurgery system: Endofreeze

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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