Improving vision for surgeons during laparoscopy: the Enhanced Laparoscopic Vision System (ELViS).

Animal model Distributed laparoscopy Enhanced visualisation Phase 0 medical device evaluation Trocar prototype

Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
05 2021
Historique:
received: 09 10 2020
accepted: 09 02 2021
pubmed: 3 3 2021
medline: 29 7 2021
entrez: 2 3 2021
Statut: ppublish

Résumé

For many abdominal surgical interventions, laparotomy has gradually been replaced by laparoscopy, with numerous benefits for the patient in terms of post-operative recovery. However, during laparoscopy, the endoscope only provides a single viewpoint to the surgeon, leaving numerous blind spots and opening the way to peri-operative adverse events. Alternative camera systems have been proposed, but many lack the requisite resolution/robustness for use during surgery or cannot provide real-time images. Here, we present the added value of the Enhanced Laparoscopic Vision System (ELViS) which overcomes these limitations and provides a broad view of the surgical field in addition to the usual high-resolution endoscope. Experienced laparoscopy surgeons performed several typical procedure steps on a live pig model. The time-to-completion for surgical exercises performed by conventional endoscopy and ELViS-assisted surgery was measured. A debriefing interview following each operating session was conducted by an ergonomist, and a System Usability Scale (SUS) score was determined. Proof of concept of ELVIS was achieved in an animal model with seven expert surgeons without peroperative adverse events related to the surgical device. No differences were found in time-to-completion. Mean SUS score was 74.7, classifying the usability of the ELViS as "good". During the debriefing interview, surgeons highlighted several situations where the ELViS provided a real advantage (such as during instrument insertion, exploration of the abdominal cavity or for orientation during close work) and also suggested avenues for improvement of the system. This first test of the ELViS prototype on a live animal model demonstrated its usability and provided promising and useful feedback for further development.

Sections du résumé

BACKGROUND
For many abdominal surgical interventions, laparotomy has gradually been replaced by laparoscopy, with numerous benefits for the patient in terms of post-operative recovery. However, during laparoscopy, the endoscope only provides a single viewpoint to the surgeon, leaving numerous blind spots and opening the way to peri-operative adverse events. Alternative camera systems have been proposed, but many lack the requisite resolution/robustness for use during surgery or cannot provide real-time images. Here, we present the added value of the Enhanced Laparoscopic Vision System (ELViS) which overcomes these limitations and provides a broad view of the surgical field in addition to the usual high-resolution endoscope.
METHODS
Experienced laparoscopy surgeons performed several typical procedure steps on a live pig model. The time-to-completion for surgical exercises performed by conventional endoscopy and ELViS-assisted surgery was measured. A debriefing interview following each operating session was conducted by an ergonomist, and a System Usability Scale (SUS) score was determined.
RESULTS
Proof of concept of ELVIS was achieved in an animal model with seven expert surgeons without peroperative adverse events related to the surgical device. No differences were found in time-to-completion. Mean SUS score was 74.7, classifying the usability of the ELViS as "good". During the debriefing interview, surgeons highlighted several situations where the ELViS provided a real advantage (such as during instrument insertion, exploration of the abdominal cavity or for orientation during close work) and also suggested avenues for improvement of the system.
CONCLUSIONS
This first test of the ELViS prototype on a live animal model demonstrated its usability and provided promising and useful feedback for further development.

Identifiants

pubmed: 33650002
doi: 10.1007/s00464-021-08369-2
pii: 10.1007/s00464-021-08369-2
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2403-2415

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Auteurs

Bertrand Trilling (B)

TIMC-IMAG Laboratory, Grenoble Alps University, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University Hospital, Grenoble, France. Btrilling@chu-grenoble.fr.
Colorectal Surgery Unit, Visceral Surgery and Acute Care Surgery Department, Grenoble Alps University Hospital, Grenoble, France. Btrilling@chu-grenoble.fr.

Adrian Mancini (A)

TIMC-IMAG Laboratory, Grenoble Alps University, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University Hospital, Grenoble, France.
Colorectal Surgery Unit, Visceral Surgery and Acute Care Surgery Department, Grenoble Alps University Hospital, Grenoble, France.

Gaëlle Fiard (G)

TIMC-IMAG Laboratory, Grenoble Alps University, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University Hospital, Grenoble, France.
Urology Department, Grenoble Alps University Hospital, Grenoble, France.

Pierre Alain Barraud (PA)

TIMC-IMAG Laboratory, Grenoble Alps University, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University Hospital, Grenoble, France.

Marion Decrouez (M)

Surgiqual Institute, Meylan, France.

Sinara Vijayan (S)

TIMC-IMAG Laboratory, Grenoble Alps University, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University Hospital, Grenoble, France.

Mathias Tummers (M)

TIMC-IMAG Laboratory, Grenoble Alps University, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University Hospital, Grenoble, France.

Jean Luc Faucheron (JL)

TIMC-IMAG Laboratory, Grenoble Alps University, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University Hospital, Grenoble, France.
Colorectal Surgery Unit, Visceral Surgery and Acute Care Surgery Department, Grenoble Alps University Hospital, Grenoble, France.

Sophie Silvent (S)

Clinical Investigation Center - Technological Innovation 1406 (CIC-IT), Grenoble University Hospital, National Institute of Health and Medical Research, Grenoble, France.

Christel Schwartz (C)

Clinical Investigation Center - Technological Innovation 1406 (CIC-IT), Grenoble University Hospital, National Institute of Health and Medical Research, Grenoble, France.

Sandrine Voros (S)

TIMC-IMAG Laboratory, Grenoble Alps University, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University Hospital, Grenoble, France.
National Institute of Health and Medical Research (INSERM), Grenoble, France.

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