Aim: During minimal access surgery an assistant is controlling the laparoscope and surgeon should be free to manipulate instruments. Although the advantages of laparoscopic surgery are well documented, one disadvantage is that, for optimum performance, an experienced camera driver is required who can provide the necessary views for the operating surgeon. There are many drawbacks in human camera operator especially if they are not trained. The self camera-control by the surgeon gives more stability of the laparoscopic image. The aim of this study was to compare PMAT camera holder device with traditional assistant-driven laparoscopic camera control.
Materials and Methods: Laparoscopic Appendicectomy, OvarianCystectomy and Laparoscopic sterilization were performed. On 14 patients, the operating surgeon used the "PMAT" and performed the surgery without a laparoscopic camera assistant. On the other group of 14 patients, an experienced camera operator was responsible for control of the laparoscopic field of vision in the traditional manner. The time required for surgery was documented.Results: The mean operative times for PMAT and camera personassisted appendicectomy was 45 minutes and 40 minutes respectively. For ovarian cystectomy 45 and 50 minutes and for laparoscopic sterilization it was 15 and 10 minutes. There were no differences in outcome of surgery or blood loss in the two groups. The operative surgeon perceived some increase in shoulder and neck pain with use of the PMAT scope holder.
Conclusions:This PMAT device provides a means for the operative surgeon to safely perform simple laparoscopic procedures alone without significantly increasing operative time or morbidity.
This work proposes a new navigation device which autonomously handles the laparoscope, with a view to reducing latency and adjusting optics in real time. The system designed is an intuitive mechatronic device with three degrees of freedom and a sole active articulation. The device uses the point of insertion as the invariant point for navigation and has a work space that closely resembles an inverted cone.
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