Comparison of orthodox versus off-optical axis endoscopic manipulations

Surgical Endoscopy
T A EmamA Cuschieri

Abstract

During complex laparoscopic operations, the surgeon often has to use both instruments to one side of the telescope (off-optical axis work). This experimental study was undertaken to compare this orthodox versus the off-optical axis endoscopic manipulations regarding the performance parameters and motion analysis and muscle work of the surgeon's dominant upper limb. Ten surgeons participated in the study; each sutured 50-mm enterotomy in pig's small bowel in each of three setups: (1) in-optical axis manipulation (one instrument on either side of the laparoscope) (2) off-optical axis manipulation (both instruments on one side of the laparoscope to the dominant hand of the surgeon), and (3) off-optical axis manipulation both instruments on one side of the laparoscope on the nondominant side). The main outcome measures were the placement error score, execution time, leakage pressure, motion analysis, and telemetric electromyography parameters of the surgeon's dominant upper limb. There was no significant difference in all parameters of performance, muscle work, and fatigue between setup 1 and setup 3. However, marked degradation of all parameters of performance with increased muscle work and fatigue was observed with setup 2 compar...Continue Reading

Citations

Apr 17, 2007·Surgical Endoscopy·Liam A HaveranDemetrius E M Litwin
Sep 26, 2008·Surgical Endoscopy·Gyusung LeeAdrian Park
May 2, 2006·Journal of Endourology·Caroline AmesJaime Landman
Mar 7, 2012·Surgical Innovation·Maria A CasseraLee L Swanström
Feb 4, 2021·Annals of Gastroenterological Surgery·Manas K RoyAshok Kumar

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