G Sroka1, M Laniado1, I Matter1, A Loveitt2, H McCollister2, K Thompson2, P Severson2. 1Bnai-Zion Medical Center, 2Minnesota Institute for Minimally Invasive Surgery
Objective: Laparoscopy has enjoyed progressive improvements over the last two decades primarily in achieving high definition, but the limited 70° field of view (FOV) remains unchanged. Complications related to events that take place out of the FOV continue to be reported, and can only be addressed by expanding the FOV. Additional problems that result in poor visualization are fogging and smoke accumulation. A novel laparoscopic system has been developed that dramatically expands the FOV from the traditional 70° to 270°, while eliminating fogging and improving smoke effects. This study describes the initial clinical experience with the SurroundScope system and its potential advantages over traditional laparoscopy.
Methods: 270Surgical has developed a revolutionary laparoscopic platform called SurroundScope. The video assembly unit controlling the FOV and image characteristics is located at the endoscope’s distal tip. The distal tip is equipped with a central color image sensor that covers an angle of 95°–115°. The distal tip also has side sensors that can extend the FOV at the press of a button to 270°. The system is also designed to eliminate fogging and improve visualization through smoke.
The 270Surgical system was studied at the Bnai Zion Medical Center in Israel and the Minnesota Institute for Minimally Invasive Surgery in America. At the time of abstract submission, 27 laparoscopic surgeries (including cholecystectomy, inguinal, ventral and hiatal hernias, sleeve gastrectomy, adrenalectomy and colectomy) were performed. All procedures were video recorded. At the end of each procedure, evaluation were completed by all surgeons and camera holders.
Results: All 27 clinical cases were completed successfully. There were no adverse events related to SurroundScope. No injuries occurred as a result of surgical tool manipulation outside of the central screen while 133 potentially adverse events were identified on the side screens. There was no fogging across the 27 cases. The impact of smoke was negligible in all cases, as the number of incidents requiring scope removal or venting was zero. Surgeon respondents indicated that the tools could be followed from the port to the site of surgery 71-100% of the time without camera manipulation, as a result of port visibility on the side screens. Most surgeons strongly agreed that the potential to identify bleeding was improved. Most camera holders strongly agreed that the ergonomics were acceptable, that the system was intuitive, and that they moved the camera less than with a standard laparoscope. Both surgeons and camera holders agreed that coordination between surgeon and camera holder may be improved, and the learning curve may be shorter when compared to standard laparoscopy.
Conclusion: Initial results demonstrate numerous advantages for the 270Surgical SurroundScope system as compared to traditional laparoscopy. The potential important benefits (the expanded FOV, the complete lack of fogging, and the negligible smoke impact) include improvements in safety and surgical techniques, duration of surgery, and a reduction in adverse events. Further investigation to quantify these benefits is recommended based on this initial clinical experience. The 270Surgical system has the potential to improve laparoscopy and expand the reaches of minimally invasive surgery.
This abstract was accepted for Podium presentation at the 2020 SAGES Virtual Meeting in the topic. Its program number was: ET012 and its Abstract ID was: 106733