A Touch-Controlled Laparoscope Manipulator: Preliminary Trial to Evaluate the Performance on Female Porcine Pelvic Surgery and an Initial Experience in A Human Robot-Assisted Laparoscopic Segmental Salpingectomy

Abstract

Background: A laparoscope manipulator enables the surgeon to perform an advanced surgery by offering the ability to stabilize and control the visual field. However, there are several problems to be solved such as difficulties to control and a long set-up time causing prolonged operating time. The novel laparoscope manipulating robot (KhonKaen-LMR) was introduced to overcome these problems. Methods: To evaluate the feasibility and safety of KhonKaen-LMR in real robot-assisted pelvic surgeries, the study was divided into 2 experiments. The first experiment was performed in live porcine robot-assisted pelvic surgeries and the second was in a robot-assisted human laparoscopic segmental salpingectomy. Results: The first experiment was performed in ten operations in three-month-old female pigs. The horizontal motion of the scope was from -25 degrees to +30 degrees (55 degree span) and the vertical motion of the scope was from 24 degrees to 51 degrees (27 degree span). The median optimal depth of the laparoscope position was 9.5 cm (range 6 -12.5 cm). The median duration of machine set-up was 3 min (range, 2-11 min). The incised wounds showed no accessory tears and were completely healed in 7 days post-operation. The second experiment was scheduled in a 38 year-old woman for robot-assisted segmental salpingectomy. The duration of setting up was 7 min. The total operating time was 22 min. The surgeon and assistants were very impressed on the convenience of the control system. The laparoscope could move directly to the target point without image rotation which was similar to being moved by an assistant. No adverse effects that were related to the range or speed were noticed. A complete recovery was encountered in 7-day follow up. Conclusion: This new laparoscope manipulator was safe and feasible to operate in humans. It seemed to be quick to set-up and easy to control.