title: Robotic versus human camera holding in video-assisted thoracic sympathectomy: a single blind randomized trial of efficacy and safety.
abstract: Our objective is to compare surgical safety and efficacy between robotic and human camera control in video-assisted thoracic sympathectomy. A randomized-controlled-trial was performed. Surgical operation was VATS sympathectomy for hyperhidrosis. The trial compared a voice-controlled robot for holding the endoscopic camera robotic group (Ro) to human assisted group (Hu). Each group included 19 patients. Sympathectomy was achieved by electrodessication of the third ganglion. Operations were filmed and images stored. Two observers quantified the number of involuntary and inappropriate movements and how many times the camera was cleaned. Safety criteria were surgical accidents, pain and aesthetical results; efficacy criteria were: surgical and camera use duration, anhydrosis, length of hospitalization, compensatory hyperhidrosis and patient satisfaction. There was no difference between groups regarding surgical accidents, number of involuntary movements, pain, aesthetical results, general satisfaction, number of lens cleaning, anhydrosis, length of hospitalization, and compensatory hyperhidrosis. The number of contacts of the laparoscopic lens with mediastinal structures was lower in the Ro group (P<0.001), but the total and surgical length was longer in this group (P<0.001). Camera holding by a robotic arm in VATS sympathectomy for hyperhidrosis is as safe but less efficient when compared to a human camera-holding assistant.
authors.affiliation: Department of Thoracic Surgery, University of São Paulo, Medical School, Heart Institute InCor, Clinics Hospital, São Paulo, Brazil.
authors.forename: Joaquim Fernando
authors.initials: JF
authors.lastname: Martins Rua
authors.forename: Fabio Biscegli
authors.initials: FB
authors.lastname: Jatene
authors.forename: José Ribas Milanez
authors.initials: JR
authors.lastname: de Campos
authors.forename: Rosangela
authors.initials: R
authors.lastname: Monteiro
authors.forename: Miguel Lia
authors.initials: ML
authors.lastname: Tedde
authors.forename: Marcos Naoyuki
authors.initials: MN
authors.lastname: Samano
authors.forename: Wanderley M
authors.initials: WM
authors.lastname: Bernardo
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Das-Neves-Pereira
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015171:Ganglionectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D012371:Robotics; D016037:Single-Blind Method; D025321:Surgery, Computer-Assisted / Q000295:instrumentation; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D020708:Thoracoscopes; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult