OREST II--ergonomic workplace and systems platform for endoscopic technologies.

Endoscopic interventions require a multitude of technical devices, like gas-insufflators, cameras, light sources, high-frequency scalpels and others. The devices available today represent stand-alone "function-insulas" from the view-point of systems technique. They have to be placed in the operating theatre and set-up right before each specific intervention. From each of these single devices supplies, cables and hoses lead to the body of the patient and have to be connected on both sides within the sterile and the non-sterile field. This not only requires a long setup time in the OR but also restricts the mobility of the operative personnel. Besides the ergonomic and the hygienic weakness of the contemporary solution, significant functional problems limit the efficiency of the OR environment. One of the major drawbacks lies in the lack of direct control of the devices by the surgeon and the confusing display of parameters and technical status. Against this background the systematic revision of the current endo-surgical workplace appears to be a major requirement for further technical and surgical progress. As a result of close cooperation between surgeons and engineers a systems workplace for minimally invasive surgery, OREST, has been developed and clinically tested. It integrates all devices into a mobile cabinet. The single devices are connected to a central computer and can be remote controlled directly by the surgeon from the table. A special display continuously informs about the system status. The lines and cables are guided into the sterile field by means of a swivel arm from one side of the patient. Multi-plugs are used to connect all lines at a central terminal within the sterile area. Clinical application of the first prototype OREST I started in 1993. OREST II is now available as a series product. Further development is focused on the integration of advanced sub-systems like tactile devices and advanced vision system.