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Combining of ETHOS Operating Ergonomic Platform, Three-dimensional Laparoscopic Camera, and Radius Surgical System Manipulators Improves Ergonomy in Urologic Laparoscopy: Comparison with Conventional Laparoscopy and da Vinci in a Pelvi Trainer.
Tokas, Theodoros; Gözen, Ali Serdar; Avgeris, Margaritis; Tschada, Alexandra; Fiedler, Marcel; Klein, Jan; Rassweiler, Jens.
Affiliation
  • Tokas T; Department of Urology and Andrology, General Hospital Hall in Tirol, Hall in Tirol, Austria; Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany. Electronic address: ttokas@yahoo.com.
  • Gözen AS; Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany.
  • Avgeris M; Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Athens, Athens, Greece.
  • Tschada A; Medical School Mannheim, University of Heidelberg, Heidelberg, Germany.
  • Fiedler M; Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany.
  • Klein J; Department of Urology, University of Ulm, Ulm, Germany.
  • Rassweiler J; Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany.
Eur Urol Focus ; 3(4-5): 413-420, 2017 10.
Article in En | MEDLINE | ID: mdl-28753821
ABSTRACT

BACKGROUND:

Posture, vision, and instrumentation limitations are the main predicaments of conventional laparoscopy.

OBJECTIVE:

To combine the ETHOS surgical chair, the three-dimensional laparoscope, and the Radius Surgical System manipulators, and compare the system with conventional laparoscopy and da Vinci in terms of task completion times and discomfort. DESIGN, SETTING, AND

PARTICIPANTS:

Fifteen trainees performed the three main laparoscopic suturing tasks of the Heilbronn training program (IV simulation of dorsal venous complex suturing; V circular suturing of tubular structure; and VI urethrovesical anastomosis) in a pelvi trainer. The tasks were performed conventionally, utilizing the three devices, and robotically. Task completion times were recorded and the surgeon discomfort was evaluated using questionnaires. OUTCOME MEASUREMENTS AND STATISTICAL

ANALYSIS:

Task completion times were compared using nonparametric Wilcoxon signed rank test and ergonomic scores were compared using Pearson chi-square test. RESULTS AND

LIMITATIONS:

The use of the full laparoscopic set (ETHOS chair, three-dimensional laparoscopic camera, Radius Surgical System needle holders), resulted in a significant improvement of the completion time of the three tested tasks compared with conventional laparoscopy (p<0.001) and similar to da Vinci surgery. After completing Tasks IV, V, and VI conventionally, 12 (80%), 13 (86.7%), and 13 (86.7%) of the 15 trainees, respectively, reported heavy total discomfort. The full laparoscopic system nullified heavy discomfort for Tasks IV and V and minimized it (6.7%) for the most demanding Task VI. Especially for Task VI, all trainees gained benefit, by using the system, in terms of task completion times and discomfort. The limited trainee robotic experience and the questionnaire subjectivity could be a potential limitation.

CONCLUSIONS:

The ergonomic laparoscopic system offers significantly improved task completion times and ergonomy than conventional laparoscopy. Furthermore, it demonstrates comparable results to robotic surgery. PATIENT

SUMMARY:

The study was conducted in a pelvi trainer and no patients were recruited.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Laparoscopy / Robotic Surgical Procedures / Surgeons / Ergonomics Type of study: Prognostic_studies Limits: Humans Language: En Journal: Eur Urol Focus Year: 2017 Document type: Article Publication country: HOLANDA / HOLLAND / NETHERLANDS / NL / PAISES BAJOS / THE NETHERLANDS

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Laparoscopy / Robotic Surgical Procedures / Surgeons / Ergonomics Type of study: Prognostic_studies Limits: Humans Language: En Journal: Eur Urol Focus Year: 2017 Document type: Article Publication country: HOLANDA / HOLLAND / NETHERLANDS / NL / PAISES BAJOS / THE NETHERLANDS