Sistema de visión global en laparoscopia / Global vision system in laparoscopy

Objetivo: La principal dificultad en la cirugía laparoscópica o robótica es la estrechez del campo de visión, restringido por el puerto de acceso del endoscopio. A ello se suma la dificultad en el manejo de los instrumentos, debida no solo al puerto de acceso, sino a la pérdida de la profundidad de campo y de la perspectiva por la ausencia de una iluminación natural. En este artículo describimos un sistema de visión global y explicamos la experiencia inicial en un modelo porcino. Material y métodos: El sistema de visión global consta de una serie de dispositivos intraabdominales, que aumentan el campo de visión y que ayudan a recuperar la perspectiva mediante la simulación de sombras naturales. Consta de una serie de cámaras de alta definición y de luces LED, que son introducidas y fijadas a la pared mediante imanes. La eficacia del sistema se ha evaluado en una varicocelectomía y en una nefrectomía. Resultado: Las diferentes cámaras intraabdominales ofrecen más puntos de visión intuitivos del área operatoria en comparación con el telescopio convencional y parece ser similar a la visión en cirugía abierta. Incluso se pueden alcanzar áreas inaccesibles al telescopio habitual. Las fuentes de luz adicionales crean sombras que aumentan la perspectiva del campo operatorio. Conclusión: Este sistema parece aumentar las posibilidades de la cirugía laparoscópica o robótica, ya que al ofrecer una visión instantánea de casi la totalidad del abdomen puede permitir realizar procedimientos más complejos, que hoy en día requieren una vía abierta

Objective: The main difficulty in laparoscopic or robot-assisted surgery is the narrow visual field, restricted by the endoscope's access port. This restriction is coupled with the difficulty of handling the instruments, which is due not only to the access port but also to the loss of depth of field and perspective due to the lack of natural lighting. In this article, we describe a global vision system and report on our initial experience in a porcine model. Material and methods: The global vision system consists of a series of intraabdominal devices, which increase the visual field and help recover perspective through the simulation of natural shadows. These devices are a series of high-definition cameras and LED lights, which are inserted and fixed to the wall using magnets. The system's efficacy was assessed in a varicocelectomy and nephrectomy.: Results The various intraabdominal cameras offer a greater number of intuitive points of view of the surgical field compared with the conventional telescope and appear to provide a similar view as that in open surgery. Areas previously inaccessible to the standard telescope can now be reached. The additional light sources create shadows that increase the perspective of the surgical field. Conclusion: This system appears to increase the possibilities for laparoscopic or robot-assisted surgery because it offers an instant view of almost the entire abdomen, enabling more complex procedures, which currently require an open pathway

Global vision system in laparoscopy. / Sistema de visión global en laparoscopia.

OBJECTIVE: The main difficulty in laparoscopic or robot-assisted surgery is the narrow visual field, restricted by the endoscope's access port. This restriction is coupled with the difficulty of handling the instruments, which is due not only to the access port but also to the loss of depth of field and perspective due to the lack of natural lighting. In this article, we describe a global vision system and report on our initial experience in a porcine model. MATERIAL AND METHODS: The global vision system consists of a series of intraabdominal devices, which increase the visual field and help recover perspective through the simulation of natural shadows. These devices are a series of high-definition cameras and LED lights, which are inserted and fixed to the wall using magnets. The system's efficacy was assessed in a varicocelectomy and nephrectomy. RESULTS: The various intraabdominal cameras offer a greater number of intuitive points of view of the surgical field compared with the conventional telescope and appear to provide a similar view as that in open surgery. Areas previously inaccessible to the standard telescope can now be reached. The additional light sources create shadows that increase the perspective of the surgical field. CONCLUSION: This system appears to increase the possibilities for laparoscopic or robot-assisted surgery because it offers an instant view of almost the entire abdomen, enabling more complex procedures, which currently require an open pathway.