Visual exposure using single-handed magnet-driven intra-abdominal wireless camera in minimal access surgery

BackgroundThe operative field of view in minimal access surgery is constrained by the location of the optical port, the direction of view of the endoscope, and the limited degrees of freedom of movement of rigid endoscopes through the access port. The aim of this study was to examine the feasibility of employing a special magnetic setup with a single external handle to fixate, drive, and orientate intra-abdominal wireless camera, and compare its visual exposure with that of a 30° endoscope.MethodsA wireless magnet-driven camera setup was developed comprising a mini wireless camera with integrated white light-emitting diodes, a specially constructed base unit for orientation control and smooth sliding motion, and an external magnetic handle to fixate and drive the camera from the outer surface of the abdominal wall. In a laboratory-based experiment, ten subjects with no laparoscopic surgical experience were asked to identify 160 randomly distributed labels in a trainer box using both a 30° endoscope and the wireless camera magnetic setup in a random order. Data were analyzed using Student’s t-test.ResultsThe mean (standard deviation) of the number of identified labels was higher using the wireless camera magnetic setup 74.8 (16.96) compared with 30° endoscope 54.7 (12.18); p < 0.001. However, the mean execution time was longer with the camera magnetic system 34.9 (4.4) min compared with the 30° endoscope 24.1 (2.8) min; p < 0.001.ConclusionThe use of the magnetic wireless camera setup with a single external handle is feasible and has demonstrated a wider visual exposure than the 30° endoscope.

[1]  D. Oleynikov,et al.  Miniature robots can assist in Laparoscopic cholecystectomy , 2005, Surgical Endoscopy And Other Interventional Techniques.

[2]  Lance Williams,et al.  View Interpolation for Image Synthesis , 1993, SIGGRAPH.

[3]  R. Eliakim,et al.  A novel diagnostic tool for detecting oesophageal pathology: the PillCam oesophageal video capsule , 2004, Alimentary pharmacology & therapeutics.

[4]  Jason Dumpert,et al.  Toward in vivo mobility. , 2005, Studies in health technology and informatics.

[5]  Mei Han,et al.  Interactive construction of 3D models from panoramic mosaics , 1998, Proceedings. 1998 IEEE Computer Society Conference on Computer Vision and Pattern Recognition (Cat. No.98CB36231).

[6]  R. Evans,et al.  Rare earth magnets in orthodontics: an overview. , 1999, British journal of orthodontics.

[7]  D R Federick,et al.  A magnetically retained interim maxillary obturator. , 1976, The Journal of prosthetic dentistry.

[8]  M. E. Rentschler,et al.  Mobile in vivo camera robots provide sole visual feedback for abdominal exploration and cholecystectomy , 2005, Surgical Endoscopy And Other Interventional Techniques.

[9]  J. Landman,et al.  Evaluation of surgical performance with standard rigid and flexible-tip laparoscopes , 2004, Surgical Endoscopy And Other Interventional Techniques.

[10]  P. Breedveld, S. Hirose.  Development of the Endo-Periscope , 2001, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[11]  Sangtae Park,et al.  Trocar-less Instrumentation for Laparoscopy: Magnetic Positioning of Intra-abdominal Camera and Retractor , 2007, Annals of surgery.

[12]  Richard Szeliski,et al.  Video mosaics for virtual environments , 1996, IEEE Computer Graphics and Applications.

[13]  J. Sandler.  An attractive solution to unerupted teeth. , 1991, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[14]  S. Davies,et al.  Retrieval of a metallic foreign body in the neck with a rare earth magnet , 2000, Journal of accident & emergency medicine.

[15]  A M Blechman,et al.  Magnetic force systems in orthodontics. Clinical results of a pilot study. , 1985, American journal of orthodontics.

[16]  Shane Farritor,et al.  In vivo robots for laparoscopic surgery. , 2004, Studies in health technology and informatics.

[17]  Guozheng Yan,et al.  From wired to wireless: a miniature robot for intestinal inspection , 2003, Journal of medical engineering & technology.

[18]  E. Verrusio,et al.  Magnetic versus mechanical expansion with different force thresholds and points of force application. , 1987, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.