Merits of a newly-developed laparoscope manipulator: experiences with 4 cases

We performed a laparoscopic splenectomy for 4 patients with liver cirrhosis, using a newly-developed laparoscope manipulator that we recently developed. The manipulator was designed for safety and easy control. The manipulator is based on a five-bar linkage mechanism that has two independent motors on the bottom. Also, a zoom-up mechanism of laparoscope was applied to this manipulation system. The moving range was about 25 degrees for both vertical and horizontal directions. The operations were performed using the conventional endoscopic surgical devices or autosuture devices under the laparoscopic view controlled by the manipulator. The laparoscopic view was superimposed by a navigating circle and bar on the videoimage. The integrated image helped the operator manipulating the conventional endoscopic surgical devices throughout the operative procedures. Two thumb-buttons were attached on the holding part of the forceps. By pressing these buttons the operator could control the zoom and the direction of the laparoscopic movement. All patients tolerated these procedures well. All procedures were performed safely and with no problem. No conversion to open surgery occurred. Both mechanical safety and easy control are feasible during laparoscopic surgery using our newly-developed laparoscope manipulator.