Robotic Camera Control ?
Mark I Robots
EndoAssist is an endoscopic surgery camera control robot which can be useful in minimally invasive thoracic and abdominal surgery.
Prosurgics Ltd describe their unique head movement control as "fast and reliable, providing the surgeon with total control at a glance". EndoAssist is programmed to detect and follow the movements of the surgeon’s head. The surgeon wears a lightweight headband fitted with an infrared emitter. The head position of the surgeon is detected by a receiver unit located on the top of the camera stack and converted into motion of the robot. So to move the view left, the surgeon simply glances to the left of the monitor and the camera pans round. To move the view up, the surgeon looks to the top of the monitor and the camera follows. Movement only occurs if the surgeon is simultaneously pressing a footswitch, thus allowing unrestricted head movements at all other times. It takes less than 2 minutes to set-up.
The Laparoscope Mounting allows the surgeon to “snap-fit” the scope to the holding arm and release at will to allow for scope cleaning. In summary, it:
- Provides a tremor free picture, enabling safer, perhaps more accurate surgery
- Puts the surgeon in control of camera movement
- Releases an assistant for more productive and rewarding activities
- Useful in urological, bariatric and general surgery
Bristol Laparoscopic Associates have been reasonably impressed with EndoAssist, finding it very useful in operations that require accurate positioning that needs to be maintained for long periods of time eg., radical prostatectomy and partialnephrectomy.
It also works very well in laparoscopic cholecystectomy and although we have never used it for CBD explorationit ought to be an asset. It ought to be good for fundoplication to. It is probably only useful in TEP hernia repair if you are a slow operator and use two or three operating ports.
We must confess that have not found it very useful in colorectal procedures where 270 degree movement of the laparoscope is a not uncommon requirement. It might be useful for TME and possibly bariatric surgery. Try it!
Bristol Laparoscopic Associates have found it a useful aid for freeing up hands to assist our trainees, particularly with radical nephrectomy.
Mark II Robots
The FreeHand robotic camera holder is the first of Prosurgics' next generation of affordable robotics (approximately £10,000 for the kit and £150 disposables/case).
The robotic limb is attached to the operating table opposite to the surgeon.
The articulating joint is stationed about 48cm above the camera port.
Its long, jointed arm allows it to be positioned for any size of patient, from the very slight to the very obese. The patient can be:
- on their side or supine
- with or without stirrups
- head up or head down
- with the table flat, tilted or broken
FreeHand allows the surgeon:
fairly immediate and precise control of scope position
rock steady image which allows for great clarity
Simple to control, inoptrusive and efficient
The scope is as before moved by the unobtrusive hands-free controller worn on a head band and an activation pedal. Mounted on the stack next to the monitor, an indicator unit shows the direction selected for the scope movement. The surgeon simply selects the direction of tilt and using head movements, initiates the movement using the activation pedal. As soon as the foot is removed from the pedal the movement stops. The scope is now held stationary until the pedal is pressed again.
To zoom the scope in or out of the port, a swift tap on the activation pedal changes FreeHand to 'zoom mode'. Once again movement is initiated when the foot pedal is pressed and ceases when it is released. Simple and effective!
The speed of scope movement can be adjusted via the speed selector panel. There are three speeds available. There is also a mannual override capability.
This piece of kit is very good and in our hands shaves about 45mins off a laparoscopic prostatectomy!
Headquarters & Worldwide Sales Office
Knaves Beech Business Centre
Loudwater, High Wycombe
T: + 44 (0) 1628 536900
F: + 44 (0) 1628 536901
Prosurgics Inc., USA
10121 Miller Avenue, Suite 205
Cupertino, CA 95014
T: (Toll Free) 1-877-ROBOT11
T: +1 408 207 0600
F: +1 408 207 0599
Prosurgics Ltd, Germany
T: (Toll Free) 0800 7544488