Surgeon workload and motion efficiency with robot and human laparoscopic camera control

Abstract

In terms of impact on surgeon motion efficiency and operative time under normal surgical conditions, RACC is essentially the same as an expert human driver. However, careful planning and structuring of the surgical suite may yield some small gains in operative time.

Ergonomic risk associated with assisting in minimally invasive surgery

“…One study investigated the application of an electromagnetic motion tracking system for simple measurements of the movements of the camera and holding arm [40]. Another study compared motion efficiencies measured from human camera drivers and robot-assisted camera control [41].…”

The AESOP robot system in laparoscopic surgery: Increased risk or advantage for surgeon and patient?

“…The large experience of our assistants, who had an average of 100 assistancies was the main reason for this finding [11]. Experienced assistants can anticipate the next surgical step and are therefore able to guide the camera almost independently [14]. Accordingly, we found a reduction in the number of necessary commands with increasing experience of the camera assistant.…”

“…Further corrective commands or even manual adjustments are then necessary, increasing the stress on the surgeon and prolonged the operating time. Moreover, the surgeon might be tempted to operate in one plane only or at the screen's margins, thus losing optimal focus on the surgical site [14]. When using a 30°angle optic, we noticed a lack of rotational mobility on the side of the robot arm [3,22]; the human assistant however, can achieve even difficult picture settings with the help of rotation.…”

Development of a compact laparoscope manipulator (P-arm)

“…The setting times were 66, 93, and 104 s and the detaching times were 24 and 17 s, respectively. Several reports have noted extended preparation time for the robot [9]. Omote reported that the operation time with laparoscope controlling robot was 54 min compared with the time without the robot of 60 min.…”

“…The bulky manipulator and the supporting arm often interfere with the positioning of the ports and the procedures [7,8]. The setting and detaching of the robot is frequently awkward, causing an extension of the time required for the operation [9,10]. Recently, laparoscopic surgery has been indicated for various procedures, some of which require the tilting of the operating table during the procedure.…”