Abstract
Background
Conventional laparoscopy offers great benefits to our patients, but suffers from major technical drawbacks. Advanced laparoscopic systems are being developed adressing some of these drawbacks.
Methods
We performed a training-box based study, performing laparoscopic tasks using conventional laparoscopy and advanced laparoscopic systems in order to assess the influence of these technical drawbacks in order to predict where the biggest advantages of newly developed surgical systems can be expected.
Results
The most significant technical drawbacks were two-dimensional vision, disturbed eye-hand target axis and (possibly to a lesser extent) the rigid instruments with a limited five degrees of freedom.
Conclusion
Major advances in advanced laparoscopy might only be expected using console-based robot-arm manipulated systems like the daVinci surgical system, or a combination of a high-quality 3-dimensional vision system, restoration of the eye-hand-target axis and the use of an advanced handheld instrument offering seven degrees of freedom such as the Radius surgical system.
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References
Berguer R, Forkey DL, Smith WD (2001) The effect of laparoscopic instrument working angle on surgeons’ upper extremity workload. Surg Endosc 15: 1027–1029
Cheah WK, Lenzi JE, So J, et al. (2001) Evaluation of a head-mounted display (HMD) in the performance of a simulated laparoscopic task. Surg Endosc 15: 990–991
Crothers IR, Gallagher AG, McClure N, et al. (1999) Experienced laparoscopic surgeons are automated to the “fulcrum effect”: an ergonomic demonstration. Endoscopy 31: 365–369
Emam TA, Hanna G, Cushieri A (2002) Ergonomic principles of task alignment, visual display, and direction of execution of laparoscopic bowel suturing. Surg Endosc 16: 267–271
Garcia-Ruiz A, Gagner M, Miller JH, et al. (1998) Manual versus robotically assisted laparoscopic surgery in the performance of basic manipulation and suturing tasks. Arch Surg 133: 957–961
Hanly EJ, Talamini MA (2004) Robotic abdominal surgery. Am J Surg 188(Suppl): 19S–26S
Hazey JW, Melvin WS (2004) Robot-assisted general surgery. Semin Laparosc Surg 11: 107–112
Herron DM, Lantis JC 2nd, Maykel J, et al. (1999) The 3-D monitor and head-mounted display. A quantitative evaluation of advanced laparoscopic viewing technologies. Surg Endosc 13: 751–755
Hofmeister J, Frank TG, Cushieri A, et al. (2001) Perceptual aspects of two-dimensional and stereoscopic display techniques in endoscopic surgery: review and current problems. Semin Laparosc Surg 8: 12–24
Jordan JA, Gallagher AG, McGuinan J, et al. (2000) Randomly alternating image presentation during laparoscopic training leads to a faster automation to the “fulcrum” effect. Endoscopy 32: 317–321
Moorthy K, Munz Y, Dosis A, et al. (2004) Dexterity enhancement with robotic surgery. Surg Endosc 18: 790–795
Mueller MD, Camartin C, Dreher E, et al. (1999) Three-dimensional laparoscopy. Gadget or progress? A randomized trial on the efficacy of three-dimensional laparoscopy. Surg Endosc 13: 469–472
Prasad SM, Maniar HS, Soper NJ, et al. (2002) The effect of robotic assistance on learning curves for basic laparoscopic skills. Am J Surg 183: 702–707
Scott DJ, Young WN, Tesfay ST, et al. (2001) Laparoscopic skills training. Am J Surg 182: 137–142
Subramonian K, DeSylva S, Bishai P, et al. (2004) Acquiring surgical skills: a comparative study of open versus laparoscopic surgery. Eur Urol 45: 346–351
Taffinder N, Smith SG, Huber J, et al. (1999) The effect of a second-generation 3D endoscope on the laparoscopic precision of novices and experienced surgeons. Surg Endosc 13: 1087–1092
Usui S, Inoue H, Yoshida T, et al. (2004) Preliminary report of multi degrees of freedom forceps for endoscopic surgery. Surg Laparosc Endosc Percut Techn 14: 66–72
van Bergen P, Kunert W, Buess GF (1999) Three-dimensional (3-D) video systems: bi-channel or single-channel optics? Endoscopy 31: 732–737
Yohannes P, Rotariu P, Pinto P, et al. (2002) Comparison of robotic versus laparoscopic skills: is there a difference in learning curve? Urology 60: 39–45
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Heemskerk, J., Zandbergen, R., Maessen, J.G. et al. Advantages of advanced laparoscopic systems. Surg Endosc 20, 730–733 (2006). https://doi.org/10.1007/s00464-005-0456-3
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DOI: https://doi.org/10.1007/s00464-005-0456-3