title: Telelap Alf-X: a novel telesurgical system for the 21st century.
abstract: OBJECTIVE
  To introduce a new telesurgical concept and system, we describe the TELELAP Alf-X system and report the results of the preliminary laboratory experiments on dry lab skill exercises.
  
  
  METHODS
  The TELELAP Alf-X system offers a novel approach to remotely operated 3-dimension endoscopy by adding haptic sensation, an eye-tracking system, and a high degree of configuration versatility. The Alf-X system consists of a remote control unit, manipulator arms, connection node, and reusable endoscopic instruments. To test the hand-eye coordination, manual dexterity, depth offield, and ability to make optimal sutures and knots, the Alf-X system was used in a laparoscopic trainer utilizing specific tools by a single surgeon (SG) who repeated three different exercises ten times. The time and accuracy of the exercises were recorded.
  
  
  RESULTS
  By using the TELELAP Alf-X system, the surgeon was able to work repeatedly and to perform all the exercises scheduled. In all exercises, the best results were achieved after the first five cases.
  
  
  CONCLUSIONS
  The TELELAP Alf-X system shows excellent stability, easy-to-use interface, and ability to perform essential endoscopic skills. Further experimentation, especially in live tissue, could identify the role of this new technology for the surgical repertoire.
authors.affiliation: Department of Surgical Science, G.D'Annunzio University School of Medicine, Chieti-Pescara, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Gidaro
authors.forename: Maurizio
authors.initials: M
authors.lastname: Buscarini
authors.forename: Emilio
authors.initials: E
authors.lastname: Ruiz
authors.forename: Michael
authors.initials: M
authors.lastname: Stark
authors.forename: Anna
authors.initials: A
authors.lastname: Labruzzo
mesh_terms: D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D020706:Laparoscopes; D008328:Man-Machine Systems; D012371:Robotics / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D017216:Telemedicine / Q000295:instrumentation* / Q000379:methods; D014110:Touch; D014584:User-Computer Interface