Evaluation of a remote-controlled laparoscopic camera holder for basic laparoscopic skills acquisition: a randomized con
- PDF / 1,093,806 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 84 Downloads / 212 Views
and Other Interventional Techniques
Evaluation of a remote‑controlled laparoscopic camera holder for basic laparoscopic skills acquisition: a randomized controlled trial Mohammad S. A. Amin1 · Abdullatif Aydin1 · Nurhan Abbud1 · Ben Van Cleynenbreugel2,9 · Domenico Veneziano3,9 · Bhaskar Somani4,9 · Ali Serdar Gözen5,9 · Juan Palou Redorta6,9 · M. Shamim Khan1,7 · Prokar Dasgupta1,7 · Jonathan Makanjuoala8 · Kamran Ahmed1,8,9 Received: 23 May 2020 / Accepted: 17 August 2020 © The Author(s) 2020
Abstract Background Unsteady camera movement and poor visualization contribute to a difficult learning curve for laparoscopic surgery. Remote-controlled camera holders (RCHs) aim to mitigate these factors and may be used to overcome barriers to learning. Our aim was to evaluate performance benefits to laparoscopic skill acquisition in novices using a RCH. Methods Novices were randomized into groups using a human camera assistant (HCA) or the FreeHand v1.0 RCH and trained in the (E-BLUS) curriculum. After completing training, a surgical workload questionnaire (SURG-TLX) was issued to participants. Results Forty volunteers naïve in laparoscopic skill were randomized into control and intervention groups (n = 20) with intention-to-treat analysis. Each participant received up to 10 training sessions using the E-BLUS curriculum. Competency was reached in the peg transfer task in 5.5 and 7.6 sessions for the ACH and HCA groups, respectively (P = 0.015), and 3.6 and 6.8 sessions for the laparoscopic suturing task (P = 0.0004). No significance differences were achieved in the circle cutting (P = 0.18) or needle guidance tasks (P = 0.32). The RCH group experienced significantly lower workload (P = 0.014) due to lower levels of distraction (P = 0.047). Conclusions Remote-controlled camera holders have demonstrated the potential to significantly benefit intra-operative performance and surgical experience where camera movement is minimal. Future high-quality studies are needed to evaluate RCHs in clinical practice. Trial registration ISRCTN 83733979 Keywords Robotic camera holder · Laparoscopy · E-BLUS · Surgical skills · Human error Many technical limitations of laparoscopic surgery are overcome with robot-assisted surgery, but due to socioeconomic factors laparoscopy remains the favoured modality for many trusts [1]. However, despite laparoscopy’s widespread application most research has focused on improving robot-assisted surgery. As such, some of the disadvantages of laparoscopic surgery e.g. operation duration, complication, and mortality still exist and may be improved upon by addressing the challenges of the learning curve (LC) [2–7]. Laparoscopy’s difficult LC is attributed to the increased workload when compared to open surgery as maintaining challenging physical positions increases stress, physical * Kamran Ahmed [email protected]
demand, and reduces performance [8–10]. Furthermore, errors made by human camera assistants (HCAs) due to inexperience, miscommunication, tremor, involuntary rotation of the camera’s a
Data Loading...
