Deparment of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands.
Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Surg Endosc. 2018 May;32(5):2560-2566. doi: 10.1007/s00464-017-5957-3. Epub 2017 Nov 3.
Robotic camera holders for endoscopic surgery have been available for 20 years but market penetration is low. The current camera holders are controlled by voice, joystick, eyeball tracking, or head movements, and this type of steering has proven to be successful but excessive disturbance of surgical workflow has blocked widespread introduction. The Autolap™ system (MST, Israel) uses a radically different steering concept based on image analysis. This may improve acceptance by smooth, interactive, and fast steering. These two studies were conducted to prove safe and efficient performance of the core technology.
A total of 66 various laparoscopic procedures were performed with the AutoLap™ by nine experienced surgeons, in two multi-center studies; 41 cholecystectomies, 13 fundoplications including hiatal hernia repair, 4 endometriosis surgeries, 2 inguinal hernia repairs, and 6 (bilateral) salpingo-oophorectomies. The use of the AutoLap™ system was evaluated in terms of safety, image stability, setup and procedural time, accuracy of imaged-based movements, and user satisfaction.
Surgical procedures were completed with the AutoLap™ system in 64 cases (97%). The mean overall setup time of the AutoLap™ system was 4 min (04:08 ± 0.10). Procedure times were not prolonged due to the use of the system when compared to literature average. The reported user satisfaction was 3.85 and 3.96 on a scale of 1 to 5 in two studies. More than 90% of the image-based movements were accurate. No system-related adverse events were recorded while using the system.
Safe and efficient use of the core technology of the AutoLap™ system was demonstrated with high image stability and good surgeon satisfaction. The results support further clinical studies that will focus on usability, improved ergonomics and additional image-based features.
用于内窥镜手术的机器人摄像头支架已经问世 20 年，但市场渗透率仍然很低。目前的摄像头支架可以通过语音、操纵杆、眼球追踪或头部运动来控制，这种转向方式已经被证明是成功的，但由于对手术流程的干扰过大，因此无法广泛推广。Autolap™系统（以色列 MST 公司）采用的是一种基于图像分析的全新转向理念。这种方式可能会提高接受度，实现流畅、互动和快速的转向。这两项研究旨在证明其核心技术的安全和高效性能。
共有 9 名经验丰富的外科医生在两项多中心研究中使用 Autolap™进行了总共 66 例不同的腹腔镜手术；其中 41 例胆囊切除术、13 例胃底折叠术（包括食管裂孔疝修复术）、4 例子宫内膜异位症手术、2 例腹股沟疝修补术和 6 例（双侧）输卵管卵巢切除术。从安全性、图像稳定性、设置和手术时间、基于图像的运动的准确性以及用户满意度等方面评估 Autolap™系统的使用情况。
64 例（97%）手术均成功完成。Autolap™系统的总设置时间平均为 4 分钟（04:08 ± 0.10）。与文献平均水平相比，使用该系统并未延长手术时间。两项研究中，报告的用户满意度分别为 3.85 和 3.96（满分 5 分）。超过 90%的基于图像的运动是准确的。使用该系统时未记录到任何与系统相关的不良事件。
证明了 Autolap™系统的核心技术安全且高效，具有高图像稳定性和良好的医生满意度。研究结果支持进一步的临床研究，重点关注可用性、改进的人体工程学和其他基于图像的功能。
