Panait Lucian, Rafiq Azhar, Mohamed Ahmed, Doarn Charles, Merrell Ronald C
Medical Informatics and Technology Applications Consortium, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA.
J Laparoendosc Adv Surg Tech A. 2003 Dec;13(6):387-95. doi: 10.1089/109264203322656469.
The operating room (OR) was traditionally characterized as a closed environment, in which the view of the operative field was available to the surgeon and assistant only. In laparoscopy, integration of technology into the surgical theatre has transformed surgical procedures into minimally invasive events, with viewing of the surgical field using endoscopic cameras. Similar technical advances to the open surgical environment will allow visualization and coordination of finer surgical maneuvers on standard video monitors. The objective of this study was to develop optimal protocols for performing basic open surgical maneuvers without direct viewing of the operating field, instead watching a monitor that displays the image of the surgical field captured by an endoscopic camera. The AESOP robotic arm and Alpha Virtual Port (Computer Motion, Goleta, California) were used to hold the endoscopic camera in different positions relative to the surgeon and the operative table. The surgeons conducting the study evaluated six such different setups. Based on the average time to complete the task in each of these setups and the ease of adaptation to the new working conditions, we concluded that at least one of these setups could be translated into the OR. The advantages of integrating video image enhancement over classical open surgery (OS) are that the surgical field can be magnified to perform finer maneuvers, and to share views of the surgical field with additional clinicians and trainees.
手术室（OR）传统上被视为一个封闭的环境，只有外科医生和助手能够看到手术区域。在腹腔镜手术中，将技术融入手术室已将外科手术转变为微创手术，通过内窥镜摄像头观察手术区域。类似的技术进步应用于开放手术环境，将能在标准视频监视器上实现更精细手术操作的可视化和协调。本研究的目的是制定最佳方案，在不直接观察手术区域的情况下进行基本的开放手术操作，而是观看显示由内窥镜摄像头捕获的手术区域图像的监视器。使用AESOP机器人手臂和Alpha虚拟端口（计算机运动公司，加利福尼亚州戈利塔）将内窥镜摄像头相对于外科医生和手术台置于不同位置。进行该研究的外科医生评估了六种这样不同的设置。基于在每种设置下完成任务的平均时间以及适应新工作条件的难易程度，我们得出结论，这些设置中的至少一种可以应用于手术室。与传统开放手术（OS）相比，整合视频图像增强技术的优势在于手术区域可以放大以进行更精细的操作，并与其他临床医生和实习生共享手术区域的视野。
