title: Shortened OR time and decreased patient risk through use of a modular surgical instrument with artificial intelligence.
abstract: With a limited number of access ports, minimally invasive surgery (MIS) often requires the complete removal of one tool and reinsertion of another. Modular or multifunctional tools can be used to avoid this step. In this study, soft computing techniques are used to optimally arrange a modular tool's functional tips, allowing surgeons to deliver treatment of improved quality in less time, decreasing overall cost. The investigators watched University Medical Center surgeons perform MIS procedures (e.g., cholecystectomy and Nissen fundoplication) and recorded the procedures to digital video. The video was then used to analyze the types of instruments used, the duration of each use, and the function of each instrument. These data were aggregated with fuzzy logic techniques using four membership functions to quantify the overall usefulness of each tool. This allowed subsequent optimization of the arrangement of functional tips within the modular tool to decrease overall time spent changing instruments during simulated surgical procedures based on the video recordings. Based on a prototype and a virtual model of a multifunction laparoscopic tool designed by the investigators that can interchange six different instrument tips through the tool's shaft, the range of tool change times is approximately 11-13 s. Using this figure, estimated time savings for the procedures analyzed ranged from 2.5 to over 32 min, and on average, total surgery time can be reduced by almost 17% by using the multifunction tool.
authors.affiliation: Department of Mechanical Engineering, University of Nebraska-Lincoln, Lincoln, NE, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Miller
authors.forename: Carl A
authors.initials: CA
authors.lastname: Nelson
authors.forename: Dmitry
authors.initials: D
authors.lastname: Oleynikov
mesh_terms: D001185:Artificial Intelligence; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation*; D004526:Efficiency; D018662:Fundoplication / Q000295:instrumentation*; D017143:Fuzzy Logic; D006801:Humans; D010535:Laparoscopy; D008954:Models, Biological; D012307:Risk Factors; D013525:Surgical Instruments; D013997:Time Factors; D014741:Video Recording