Aaron J Berkenwald, MD, Dmitry Nepomnayshy, MD, FACS, Mattew Rade, MD, Desmond H Birkett, MD. Lahey Medical Center
1. Objective of the technology or device
The AutoLap system, designed and manufactured by M.S.T Medical Surgery Technologies, is a robotic, table-mounted laparoscopic video camera system with a remote control. The system is designed to allow surgeons or surgical staff to provide sharp, steady images without unwanted camera motion. Additionally, the technology improves overall team ergonomics by decreasing crowding around the operating table. The goal of the AutoLap System is to maximize operative image quality, ergonomics, and efficiency by replacing a human camera holder.
2. Description of the technology and method of its use or application
The AutoLap system is an active laparoscope positioner indicated for general laparoscopic, gynecologic and urologic procedures. The system optimizes holding, aiming and focusing of a standard laparoscope within surgical cavities, during minimally invasive laparoscopic surgery. The movement of the laparoscope is under the control of the surgeon or assistants at all times. Movement is controlled by a small, sterile ring or clip with a built in joystick that allows for vertical and horizontal movement, as well as zooming in and out. The camera system software also allows for a "Follow-Me" function where the system tracks the surgeon's instruments continuously.
We applied this technology in a small study comparing the degree of erroneous, unwanted camera movement between the AutoLap system and a hand-held camera during laparoscopic surgery. Data was recorded using an accelerometer during 6-second intervals for the duration of each operation. We eliminated data representing 70% of the intervals with the highest standard deviation of movement. Below, we compare the remaining 30%, representing the volume of movement during periods of relative stillness.
3. Preliminary results
P values calculated using unpaired two tailed t-test. Accelerometer measures the movements in X,Y,Z in gravity units ([g]). Angular movement measures the angular movement around the X,Y,Z axes in rad/sec.
4. Conclusions / future directions.
Modern laparoscopic surgery places increased demands on the surgical team by requiring skilled assistants to drive the camera to optimize surgical performance. An extra person at the OR table causes crowding, which can contribute to poor intra-operative ergonomics leading to long term injury. The AutoLap system may provide a unique platform that allows surgeons to have an improved operative view and better ergonomics, while freeing up assistants to perform other tasks. We intend to report data from 30 patients, regarding overall operative experience by the surgical team, set up time and total O.R. time, in addition to operative image-stability metrics.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 84465
Program Number: ETP718
Presentation Session: Emerging Technology Poster
Presentation Type: Poster