Piezo-TEN
Semiautomatic camera holding system for laparoscopic surgery (1996 - 2002)
Background
In laparoscopic surgery especially the surgical assistant is strained by mostly static holding of the endoscope as well as by corresponding un-suitable body postures. Premature fatigue im-pairs an efficient and safe operation (by shifting and trembling of the endoscopic image, temporary loss of the focus or staining of the distal lenses by unintentional soft-tissue contact). Moreover, an additional camera assistant or a "third hand" respectively is necessary to hold the endo-camera. Partially, the simultaneous bimanual manipulation of the endo-camera and an instrument hinders exact preparation work.
Approach
Based on human factors as well as technical analysis, a modular surgical holding arm system has been developed. For the majority of endoscopic interventions, this system already significantly improves the situation described above. The PIEZOTEN-system can be operated with one hand by means of a control button on the endo-camera head. It is mounted on the standard rail of the operating table, draped by a standard sterile endo-camera drape and connected with the sterile quick adapter of the endoscope interface. The system proved to be a low cost very effective assistance in laparoscopic surgery. Investigations in other domains such as navigation in computer assisted surgery showed promising perspectives.
After successful conclusion of the veri--fication of electrical and mechanical safety of the overall system, the VDE approval for clinical trials has been achieved. Clinical testing has been successfully performed (for more information please refer to the publications incl. the research report)
Further Information
Publications
- Radermacher, K., Pichler, C. v., Rau, G.: Aspekte der Minimalen Invasiven Chirurgie - Analyse und Ansätze im Bereich der Ergonomie -. Zeitschrift für Biomedizinische Technik, Bd. 37, Ergänzungsband 2, 1992, S. 210-211
- Rau, G., C. v. Pichler, K. Radermacher: Surgical Reality. Medical Technology International, Cornhill Publications Ltd. 1995, pp.46-51
- Rau, G., Radermacher, K., Thull, B., Pichler, C. v.: Aspects of an Ergonomic System Design of a Medical Worksystem. in: Taylor, R., Lavallée, St., Burdea, G., Moesges, R. (eds.): Computer Integrated Surgery, MIT-Press, Cambridge, MA, 1996, pp.203-221
- Radermacher, K., Pichler, C. v., Erbse, St., Boeckmann, W., Rau, G., Jakse, G.: Using Human Factor Analysis and VR Simulation Techniques for the Optimization of the Surgical Worksystem. Weghorst, S.J. , Sieburg, H.B. , Morgan, K., (eds.): MMVR 4 - HealthCare in the Information Age -Future Tools for Transforming Medicin , IOS Press, 1996, pp. 532-541
- Erbse, St., Radermacher, K., Anton, M., Rau, G., Boeckmann, W., Jakse, G., Staudte, H.-W.: Development of an automatic surgical holding systembased on ergonomic analysis. in: Troccaz, J. Grimson, E., Mösges, R. (eds.): CVRMED II and MRCAS III, Lecture Notes in Computer Science, Springer-Verlag, 1997, pp. 737-746
- Radermacher, K., Erbse, St.,Winkler, M., Rau, G., Rath, W.: Einsatz eines neuen automatischen chirurgischen Kameraassistenzsystem in der gynäkologischen Laparoskopie. Zeitschrift für Biomedizinische Technik, Band 45, Ergänzungsband 1, 2000, S. 165-166
- Winkler, M., Erbse, St., Radermacher, K., Rau, G., Rath, W.: An automatic surgical camera-holding system: initialexperiences in gynecological laparoscopy. Journal of the American Association of Gynecological Laparoscopists, May 2001, Vol.8, No.2, pp. 303-306
- Stephan Erbse: Entwicklung eines chirurgischen Assistenzsystems auf der Basis piezoelektrisch arretierbarer Gelenkmechanismen, Dissertation RWTH Aachen (2002), Shaker Verlag, ISBN 978-3-8322-0425-9