Usefulness of panoramic views for novice surgeons doing retroperitoneal laparoscopic nephrectomy.
OBJECTIVE
Laparoscopic surgery is widely accepted for managing renal disease. Thus, the system used to educate and train novice surgeons in laparoscopic surgery becomes important to reduce the risks of surgery during their training. A prospective study was carried out to determine the usefulness of using panoramic views during laparoscopic surgery.


METHODS
Between April 2004 and March 2007, four novice surgeons started learning laparoscopic radical nephrectomy: two carried out surgery without panoramic views and two used panoramic views. Operating time and blood loss for the initial 10 cases of each surgeon were compared. Panoramic views were obtained by interlacing each video frame of the video images electronically; the images were then processed and displayed during each step of laparoscopic surgery.


RESULTS
Panoramic, real-time views could be obtained, and they served as navigation maps. The learning curve of surgeons using the panoramic views was shorter than that of surgeons who did not use panoramic views. Time to ligation of renal artery from port placement and the operating time was shorter (69.0 +/- 21.5 min vs 106.8 +/- 44.9 min, P = 0.0016, 212 +/- 42 min vs 254 +/- 46 min, P = 0.0489, respectively) and the estimated blood loss was less for the surgeons who used panoramic views (87 +/- 109 mL vs 334 +/- 268 mL, P = 0.0005).


CONCLUSIONS
Panoramic views during laparoscopic surgery shortened operating time and reduced blood loss, indicating their usefulness in assisting novice surgeons to carry out procedures safely and accurately.
Naya
Yukio
Y
Research Center for Frontier Medical Engineering, Chiba University, Chiba, Japan. nayayukio@faculty.chiba-u.jp
Nakamura
Kazuyoshi
K
Araki
Kazuhiro
K
Kawamura
Koji
K
Kamijima
Syuichi
S
Imamoto
Takashi
T
Nihei
Naoki
N
Suzuki
Hiroyoshi
H
Ichikawa
Tomohiko
T
Igarashi
Tatsuo
T
D006801:Humans; D007091:Image Processing, Computer-Assisted; D010535:Laparoscopy / Q000379:methods*; D009392:Nephrectomy / Q000193:education* / Q000379:methods; D011446:Prospective Studies