Skill performance in open videoscopic surgery.
BACKGROUND
Application of minimally invasive surgery represents the future of modern surgical care. Previous studies by our group provided a novel way for viewing open surgery using a rigid endoscope attached to charged coupled device (CCD) camera in proximity to the surgical field using a robotic arm (AESOP) and a stabilizing fulcrum (Alpha port).


METHODS
This study is a follow-up to investigate the technical feasibility, advantages, and disadvantages of relying only on video images displayed on standard monitors in performing open surgical procedures instead of direct binocular eye vision. This study used two surgeons as participants with training in basic surgical skill and previous experience in performing an intestinal anastomosis in an ordinary fashion. The standard task consisted of anastomosing porcine intestine in two layers with digital viewing of the operative field. A total of 40 anastomoses (20 by each surgeon) were compared with 10 control performances using direct vision of the field.


RESULTS
All the resulting anastomoses were accurate, well coapted, and fully patent with no leakage. Time for task performance was approximately twice as long (p < 0.05) with videoscopic vision as with direct vision.


CONCLUSIONS
These findings suggest it is technically feasible to conduct open surgeries with visualization of the open surgical field limited to video display on standard monitors.
Mohamed
A
A
Medical Informatics and Technology Applications Consortium, Department of Surgery, Virginia Commonwealth University, P.O. Box 980480, 1101 E. Marshall Street, Richmond, VA 23298, USA.
Rafiq
A
A
Panait
L
L
Lavrentyev
V
V
Doarn
C R
CR
Merrell
R C
RC
D000714:Anastomosis, Surgical; D000818:Animals; D002983:Clinical Competence; D005240:Feasibility Studies; D006801:Humans; D007422:Intestines / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D015203:Reproducibility of Results; D012371:Robotics; D013552:Swine; D020535:Video-Assisted Surgery / Q000592:standards