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Session: Medical Instruments - Surgery I
Session starts: Friday 25 January, 10:30
Presentation starts: 11:30
Room: Lecture room 557

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Joris Jaspers ()
Jesse Bosma ()
Arto Boeken Kruger ()

Abstract:
Holding an endoscope or other static instrumentation during Minimally Access Surgery (MAS) can be a rather fatiguing, boring and cumbersome job. Usually an assistant is in charge of this task, so that the surgeon has no direct control over his viewing direction. This easily results in communication problems and disturbance of the surgeon’s eye-hand co-ordination. Moreover, it is hard to obtain a sustained stable endoscopic view. A few systems with an endoscope holding function have been assessed, but most of these systems are expensive, complex, not intuitive to use or bulky. Previous studies showed that passive holders perform as well as or even better than active holders and as well as human control [1,2] The University Medical Center (UMC) Utrecht has developed a new holding device for endoscopic instruments. It features a simple construction that aims at user friendly operation of the device. This includes easy one-handed operation of the device and a slender design that minimizes the interference with other instruments in the sterile field. The device actually fixates all degrees of freedom of the trocar and the instrument going through it simultaneously, in a drag ‘n drop manner. Engaging the operating button of the device removes the fixation of trocar and instrument, releasing the button fixates the instrument in the desired position immediately. The button of the system can easily be attached to the instrument, which improves the intuitive way of interacting with the device even more. A prototype for clinically evaluation has been produced using a reusable holder in combination with an adjusted disposable trocar. A feasibility study in a number of Minimally Access Nefrectomies (kidney removal) showed the ease of use, the stable image and showed that solo surgery is possible, improving the operational effectiveness of the OR-team The trocar holding system showed to be a user friendly, single-hand operated device that helps to provide a stable endoscopic view and may be able to reduce OR costs for MAS. REFERENCES [1] Arezzo et al, Surgical Endoscopy 2000 [2] Den Boer et al, Surgical Endoscopy, 2001