Evaluation of a remote-controlled laparoscopic camera holder for basic laparoscopic skills acquisition: a randomized controlled trial

Abstract

Background Unsteady camera movement and poor visualization contribute to a difficult learning curve for laparoscopic surgery. Remote-controlled camera holders (RCHs) aim to mitigate these factors and may be used to overcome barriers to learning. Our aim was to evaluate performance benefits to laparoscopic skill acquisition in novices using a RCH. Methods Novices were randomized into groups using a human camera assistant (HCA) or the FreeHand v1.0 RCH and trained in the (E-BLUS) curriculum. After completing training, a surgical workload questionnaire (SURG-TLX) was issued to participants. Results Forty volunteers naïve in laparoscopic skill were randomized into control and intervention groups (n = 20) with intention-to-treat analysis. Each participant received up to 10 training sessions using the E-BLUS curriculum. Competency was reached in the peg transfer task in 5.5 and 7.6 sessions for the ACH and HCA groups, respectively (P = 0.015), and 3.6 and 6.8 sessions for the laparoscopic suturing task (P = 0.0004). No significance differences were achieved in the circle cutting (P = 0.18) or needle guidance tasks (P = 0.32). The RCH group experienced significantly lower workload (P = 0.014) due to lower levels of distraction (P = 0.047). Conclusions Remote-controlled camera holders have demonstrated the potential to significantly benefit intra-operative performance and surgical experience where camera movement is minimal. Future high-quality studies are needed to evaluate RCHs in clinical practice. Trial registration ISRCTN 83733979

A Survey of Surgical Trainees in Trinidad & Tobago Using a Robotic Laparoscopic Camera Holder

“…This can be achieved with proper training and mentorship. Several groups have shown that with structured training courses, surgical residents rapidly acquire skills and become proficient with the use of the FreeHand® robot 3,10 . There is no substantial reason for PGY4/5 residents to believe that their mentors would deny them performing an operation solely because of the presence of any surgical tool.…”

“…Robotic surgery was totally non-existent in all countries of the Anglophone Caribbean until September 15, 2021 when a FreeHand® Surgical Robot (Freehand 2010 Ltd., Guildford, Surrey, UK) was introduced in Trinidad & Tobago 2 . This robot comprises a single arm that handles the laparoscope and is controlled by the surgeon via an infrared communicator 3 .…”

Physical and mental health impairments experienced by operating surgeons and camera-holder assistants during laparoscopic surgery: a cross-sectional survey

“…The camera is controlled by the camera-holder assistant. The complex nature of laparoscopic surgery necessitates a coordinated effort between the operating surgeon and the camera-holder assistant to provide a steady view of the surgical field (2). The current research focused on improving the working environment of operating surgeons and reducing the damage to physical and mental health caused by laparoscopic surgery (3)(4)(5)(6)(7)(8).…”

Robotic Endoscope Control Via Autonomous Instrument Tracking

“…This problem aggravates for long interventions or when the assistant has to adopt particularly uncomfortable postures. Besides the ergonomic challenges, miscommunication between the surgeon and the assistant may lead to sub-optimal views ( Amin et al, 2020 ).…”