Visual exposure using single-handed magnet-driven intra-abdominal wireless camera in minimal access surgery: is better than 30 degrees endoscope.
BACKGROUND
The operative field of view in minimal access surgery is constrained by the location of the optical port, the direction of view of the endoscope, and the limited degrees of freedom of movement of rigid endoscopes through the access port. The aim of this study was to examine the feasibility of employing a special magnetic setup with a single external handle to fixate, drive, and orientate intra-abdominal wireless camera, and compare its visual exposure with that of a 30 degrees endoscope.


METHODS
A wireless magnet-driven camera setup was developed comprising a mini wireless camera with integrated white light-emitting diodes, a specially constructed base unit for orientation control and smooth sliding motion, and an external magnetic handle to fixate and drive the camera from the outer surface of the abdominal wall. In a laboratory-based experiment, ten subjects with no laparoscopic surgical experience were asked to identify 160 randomly distributed labels in a trainer box using both a 30 degrees endoscope and the wireless camera magnetic setup in a random order. Data were analyzed using Student's t-test.


RESULTS
The mean (standard deviation) of the number of identified labels was higher using the wireless camera magnetic setup 74.8 (16.96) compared with 30 degrees endoscope 54.7 (12.18); p \ 0.001. However, the mean execution time was longer with the camera magnetic system 34.9 (4.4) min compared with the 30 degrees endoscope 24.1 (2.8) min; p \ 0.001.


CONCLUSIONS
The use of the magnetic wireless camera setup with a single external handle is feasible and has demonstrated a wider visual exposure than the 30 degrees endoscope.
Fakhry
Morkos
M
Department of Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London, UK.
Gallagher
Brendan
B
Bello
Fernando
F
Hanna
George B
GB
D019723:Endoscopes; D004724:Endoscopy / Q000193:education* / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D008280:Magnetics; D013647:Task Performance and Analysis; D014741:Video Recording