Mohamed A, Rafiq A, Panait L, Lavrentyev V, Doarn C R, Merrell R C
Medical Informatics and Technology Applications Consortium, Department of Surgery, Virginia Commonwealth University, P.O. Box 980480, 1101 E. Marshall Street, Richmond, VA 23298, USA.
Surg Endosc. 2006 Aug;20(8):1281-5. doi: 10.1007/s00464-005-0696-2. Epub 2006 Jul 24.
Application of minimally invasive surgery represents the future of modern surgical care. Previous studies by our group provided a novel way for viewing open surgery using a rigid endoscope attached to charged coupled device (CCD) camera in proximity to the surgical field using a robotic arm (AESOP) and a stabilizing fulcrum (Alpha port).
This study is a follow-up to investigate the technical feasibility, advantages, and disadvantages of relying only on video images displayed on standard monitors in performing open surgical procedures instead of direct binocular eye vision. This study used two surgeons as participants with training in basic surgical skill and previous experience in performing an intestinal anastomosis in an ordinary fashion. The standard task consisted of anastomosing porcine intestine in two layers with digital viewing of the operative field. A total of 40 anastomoses (20 by each surgeon) were compared with 10 control performances using direct vision of the field.
All the resulting anastomoses were accurate, well coapted, and fully patent with no leakage. Time for task performance was approximately twice as long (p < 0.05) with videoscopic vision as with direct vision.
These findings suggest it is technically feasible to conduct open surgeries with visualization of the open surgical field limited to video display on standard monitors.
微创手术的应用代表了现代外科治疗的未来。我们团队之前的研究提供了一种新颖的方法，通过使用连接到电荷耦合器件（CCD）相机的刚性内窥镜，借助机械臂（AESOP）和稳定支点（Alpha端口）在手术区域附近观察开放手术。
本研究是一项后续研究，旨在调查仅依靠标准监视器上显示的视频图像而非直接双目视觉来进行开放手术操作的技术可行性、优点和缺点。本研究以两名接受过基本手术技能培训且有普通方式进行肠吻合术经验的外科医生作为参与者。标准任务包括对猪肠进行两层吻合，并通过数字方式观察手术视野。总共进行了40次吻合（每位外科医生20次），并与10次使用直接视野的对照操作进行比较。
所有吻合结果均准确、贴合良好且完全通畅，无渗漏。使用视频视野完成任务的时间大约是直接视野的两倍（p < 0.05）。
这些发现表明，将开放手术视野的可视化限制在标准监视器上的视频显示，在技术上是可行的。
