Gene Yang1, Jung M Kwak2, Jin Kim3, Seon H Kim3, Cristians Gonzalez2, Federico Davrieux2, Ryohei Watanabe4, Steven D Schwaitzberg1, Bernard Dallemagne4, Jacques Marescaux4. 1Department of Surgery, University at Buffalo, Buffalo, USA, 2IHU-Strasbourg, Strasbourg, France, 3Korea University College of Medicine, Seoul, South Korea, 4IRCAD, Strasbourg, France
Introduction– Minimally invasive surgery relies on optimal camera control for the successful execution of operations. One disadvantage of laparoscopic surgery is that camera control is dependent on a surgical assistant’s interpretation of visual cues and ability to predict the next field of focus in addition to verbal commands from the operating physician to provide the optimal view. Robot-assisted minimally invasive surgery provides the operating surgeon the advantage of dictating their field of view. This study aims to utilize a video processing algorithm to determine the incidence of improperly centered field of view in laparoscopic vs. robot-assisted surgery.
Methods– In this study, 8 recordings of minimally invasive resection of rectal cancer (4 laparoscopic and 4 robot-assisted surgery) were evaluated. Recordings were input into MATLAB ® video processing to generate single frames at each second interval. A single reviewer would indicate the pixel which best determined where the camera should be centered based on positioning of instruments, current action (dissection/hemostasis/traction) depicted in the frame, and previous review of recordings. Pixel locations were recorded for subsequent analysis. Centered views were determined as those with the identified centered position pixel lying within the center quadrant when frames were split into a uniform 3×3 grid. In addition, distance of each point to the absolute center of the frame was calculated based on the pixel’s x and y positions.
Results– Individual operation data was analyzed for percent of centered pixel locations and pixel distance from the center pixel of the frame. Robot-assisted surgery demonstrated higher percentage of centered views over laparoscopic surgery (61.5 ± 5.1 vs. 49.7 ± 7.8; p<0.05). Robot-assisted surgery also demonstrated shorter distances to frame center than laparoscopic surgery (123.3± 9.8 vs. 144.8 ± 13.9; p<0.05).
Conclusion– Robot-assisted surgery aims to resolve conflicts of cooperation that occur between surgeon and assistant in laparoscopic surgery by enabling manual visual control of the operative field by the operating surgeon. This study demonstrates that by eliminating such conflicts, optimal surgical view is more frequently obtained.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88567
Program Number: P478
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster