Beckmeier Luisa, Klapdor Rüdiger, Soergel Phillip, Kundu Sudip, Hillemanns Peter, Hertel Hermann
Arch Gynecol Obstet. 2014 Feb;289(2):341-8. doi: 10.1007/s00404-013-3004-8.
Surgeon-controlled endoscope leading assistance systems are a novelty in endoscopic surgery. These systems were evaluated for their applicability and reliability in operative gynecology. In this regard, we evaluated possible methods of operation, operative time, setup time, and comfort for the surgeon, complications, blood transfusions, length of stay, hemoglobin levels, and demographic data.
Two systems with technically identical camera control systems were applied, the SOLOASSISTTM system and the Einstein VisionTM 3D system. The arm systems are attached to the operating table and controlled by surgeon via a manual control, a remote control or a foot switch. Comfort for the surgeon was evaluated using a questionnaire (scale 1-5; 1 "very good", 5 "poor"). All data were collected prospectively in a database (IBM SPSS Statistics 20) and evaluated.
One hundred and four patients underwent surgery supported by an active control system. In 43 (41 %) cases, oncological interventions were performed. Average setup time was 7 (3-30) min. There was a significant learning curve regarding the mounting of the system after 20 operations (p = 0.045). Overall comfort was rated as "good", divided into control 2.2 (2-4), physical effort 2.1 (1-4), picture quality 1.6 (1-3), and overall satisfaction 2.1 (1-4). About 75 unwanted camera movements were noticed in 104 surgeries. Complications occurred in no case (0 %).
The application of an active camera control system was evaluated to be safe for all gynecological laparoscopies. Picture blur is avoided even during prolonged complex procedures. Moreover, the assistant is able to support the surgeon with two instruments, with the result that the presence of a second assistant is not required for complex interventions. Causing only minimal setup time, the examined active control systems improve the effectiveness of surgeries. The physical effort required for the assistant decreases and, by reducing tiring operations and tremor, subsequently, higher precision is reached.
外科医生控制的内镜引导辅助系统是内镜手术中的一项新技术。对这些系统在妇科手术中的适用性和可靠性进行了评估。在这方面，我们评估了可能的操作方法、手术时间、设置时间、外科医生的舒适度、并发症、输血情况、住院时间、血红蛋白水平和人口统计学数据。
应用了两个技术上相同的摄像头控制系统的系统，即SOLOASSISTTM系统和爱因斯坦视觉TM 3D系统。臂系统连接到手术台上，由外科医生通过手动控制、遥控或脚踏开关进行控制。使用问卷（1-5级；1“非常好”，5“差”）对外科医生的舒适度进行评估。所有数据均前瞻性收集到数据库（IBM SPSS Statistics 20）中并进行评估。
104例患者在主动控制系统的支持下接受了手术。其中43例（41%）进行了肿瘤干预。平均设置时间为7（3-30）分钟。在20例手术后，系统安装方面存在显著的学习曲线（p = 0.045）。总体舒适度被评为“良好”，分为控制2.2（2-4）、体力消耗2.1（1-4）、图像质量1.6（1-3）和总体满意度2.1（1-4）。在104例手术中发现约75次不必要的摄像头移动。无一例发生并发症（0%）。
主动摄像头控制系统的应用被评估为对所有妇科腹腔镜手术都是安全的。即使在长时间的复杂手术过程中也能避免图像模糊。此外，助手能够用两种器械支持外科医生，因此复杂干预无需第二名助手在场。所检查的主动控制系统设置时间极短，提高了手术效率。助手所需的体力消耗减少，通过减少疲劳操作和震颤，随后可达到更高的精度。
