Utility of a voice-activated system in minimally invasive surgery.
BACKGROUND
Advances in computer enhancements for surgery, including a voice-activated control system for minimally invasive surgery, are being introduced into clinical practice. Few reports have objectively evaluated the utility of the voice-activated control system. The aim of this study was to evaluate the utility of a voice-activated control system for delivery of commands to specific operating room (OR) equipment.


METHODS
We evaluated a total of 30 laparoscopic procedures: 15 laparoscopic hernia repairs, 10 laparoscopic cholecystectomies, and 5 laparoscopic fundoplications performed with the HERMEStrade mark Operating Room Control Center (Computer Motion, Santa Barbara, California) voice-activated control system. When the voice command (VC) to the HERMES system was given, the circulating nurse was observed and her location was recorded. The 3 locations were A, the nurse was immediately available in the OR, not engaged in any other tasks; B, the nurse was in the OR but engaged in other tasks; or C, the nurse was outside the OR.


RESULTS
The 30 cases were performed by the same surgeon and completed laparoscopically. For 170 VCs for gas insufflation, the location of the circulating nurse was: A=50, B=98, and C=22. For 135 light source adjustments, the locations were A=34, B=82, and C=19. In 76 white balance VCs: A=16, B=51, and C=9. In 128 VCs for camera adjustment: A=27, B=77, and C=24. Eight video capture VCs: A=1, B=3, and C=4. For 69 image capture VCs: A=5, B=41, and C=23. The total number of VCs was 586: A=133 (22.7%), B=352 (60%), and C=101(17.3%). All VCs were accurately interpreted by the HERMES system.


CONCLUSIONS
Voice-activated control systems improve communication with and efficiency of OR staff. The surgeon is afforded the most timely equipment adjustment possible. Circulating nurses are allowed to concentrate on patient care instead of equipment adjustment during the course of the surgery.
Salama
Ibrahim Abdelkader
IA
Department of Surgery and the Paul Piece Center for Minimally Invasive Surgery, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA.
Schwaitzberg
Steven D
SD
D006801:Humans; D010535:Laparoscopy; D049250:Speech Recognition Software; D025321:Surgery, Computer-Assisted; D014584:User-Computer Interface; D014831:Voice