Minimally Invasive Surgery Program, Legacy Health System, 1040 NW 22nd Avenue, Suite 560, Portland, OR 97210, USA.
Surg Endosc. 2009 Dec;23(12):2720-7. doi: 10.1007/s00464-009-0476-5. Epub 2009 Apr 10.
A unique endoscopic platform with two independent end-effectors, each with five degrees of freedom, and an ergonomic user interface has been developed to address the needs of complex endolumenal and natural orifice translumenal endoscopic surgery (NOTES) procedures. This study aimed to measure the amount this new platform would improve performance for bimanual coordination compared with a standard dual-channel scope using a benchtop simulation.
Task 1 involved 12 individuals performing an identical bimanual coordination task with two different devices: a dual-channel endoscope (DCE) and the EndoSAMURAI prototype. The participants were separated into three groups with different levels of endoscopy and NOTES experience. A complex bimanual coordination task (pin transfer) was used. For this task, 12 pins had to be manipulated in a predetermined order. Performance was measured by movement speed, and accuracy. Comparisons were made between the two devices and the three groups of subjects. Task 2 required the same 12 participants to perform a standardized intracorporeal suture in a NOTES simulation.
In the pin transfer task, overall performance speed was significantly faster using the EndoSAMURAI (304 ± 125 s) rather than the DCE (867 ± 312 s; P < 0.001). The difference between the two operating systems was more pronounced in the student group than in the surgeon group: experts (226 ± 41 vs. 620 ± 277 s), surgeons (333 ± 152 vs. 930 ± 283 s), students (318 ± 83 vs. 1021 ± 423 s). Accuracy, as indicated by the number of pin drops, also was significantly better using the EndoSAMURAI (0.4) rather than the DCE (1.8 drops; P = 0.006). In addition, all 12 participants were able to complete a suture using the EndoSAMURAI, but none could complete a suture using the DCE.
The EndoSAMURAI enhances performance times and accuracy in complex surgical tasks compared with the conventional therapeutic endoscope.
为满足复杂内镜腔内和经自然腔道内镜外科（NOTES）手术的需求，开发了一种具有两个独立末端执行器、每个末端执行器具有五个自由度和符合人体工程学的用户界面的独特内镜平台。本研究旨在通过台架模拟测量与标准双通道内镜（DCE）相比，该新平台在双手协调方面的性能提升程度。
任务 1 涉及 12 名个体使用两种不同设备完成相同的双手协调任务：DCE 和 EndoSAMURAI 原型。参与者分为具有不同内镜和NOTES 经验水平的三组。使用复杂的双手协调任务（针转移）。在此任务中，必须按预定顺序操纵 12 根针。通过运动速度和准确性来衡量性能。对两种设备和三组受试者进行了比较。任务 2要求 12 名相同的参与者在NOTES 模拟中完成标准化的腔内缝合。
在针转移任务中，使用 EndoSAMURAI（304±125 s）的整体操作速度明显快于 DCE（867±312 s；P<0.001）。在学生组中，两个操作系统之间的差异比在外科医生组中更为明显：专家（226±41 vs. 620±277 s）、外科医生（333±152 vs. 930±283 s）、学生（318±83 vs. 1021±423 s）。使用 EndoSAMURAI（0.4 个）的准确性也明显优于 DCE（1.8 个针掉落；P=0.006）。此外，所有 12 名参与者均能够使用 EndoSAMURAI 完成缝合，但没有一名参与者能够使用 DCE 完成缝合。
与传统的治疗性内镜相比，EndoSAMURAI 可提高复杂手术任务的操作时间和准确性。
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