Solo-surgical laparoscopic cholecystectomy with a joystick-guided camera device: a case–control study

• DOI: 10.1007/s00464-013-3142-x
• Publication Date: 2013-08-28T20:12:52Z
• Authors: Sonja Gillen; Benedikt Pletzer; Arthur Heiligense...; Petra Wolf; Jörg Kleeff; Hubertus Feussner; Alois Fürst
• Keywords: Adult; Male; 2. Zero hunger; Adolescent; Operative Time; Equipment Design; Robotics; Length of Stay; Middle Aged; 3. Good health; Young Adult; 03 medical and health sciences; Postoperative Complications; Treatment Outcome; 0302 clinical medicine; Cholecystectomy, Laparoscopic; Surgery, Computer-Assisted; Case-Control Studies; Germany; Humans; Female; Aged

This study aimed to evaluate the implementation of a joystick-controlled camera holder (Soloassist; Actormed, Barbing, Germany) in laparoscopic cholecystectomy as so-called solo-surgery compared with the standard operation.Of the 123 patients included in this study, 63 underwent laparoscopic cholecystectomy using the Soloassist system and were compared with 60 patients who underwent laparoscopic cholecystectomy with human assistance. The two groups did not differ significantly in terms of age, sex, body mass index, or American Society of Anesthesiology classification. The surgeons were divided into those highly experienced and those experienced with the new camera holder. The operation times were measured, including setup and dismantling of the system. The assessment also included complications, postoperative hospital stay, measurement of human resources in terms of personnel/minutes/operation, and subjective evaluation of the camera-guiding device by the surgeons.The hospital stay and operation-related complications were not enhanced in the Soloassist group. The differences in core operation time (p = 0.008) and total operating time (p = 0.001) significantly favored the human assistant. Whereas the absolute duration of surgery was longer, the relative operating time (in personnel/minutes/operation) was significantly shorter (p < 0.001). In 4.8 % of the cases, the operation could not be performed completely with the camera-holding device. Clinically relevant postoperative complications did not occur. The experience of the surgeons did not differ significantly. The subjective evaluation regarding handling, image quality, effort, and satisfaction demonstrated high acceptance of the Soloassist system.The camera-guiding device can be implemented without increased complications. The Soloassist system is safe and can be operated even by colleagues without system experience. All the surgeons rated their satisfaction with the system as very good to excellent. Although the operating times were longer than with the standard camera guidance, the absolute overall staff time was reduced.