Abstract
Purpose
In endoscopic surgery such as video-assisted thoracoscopic surgery and laparoscopic surgery, providing the surgeon a good view of the target is important. Rigid endoscope has for years been the go-to tool for this purpose, but it has certain limitations like the inability to work around obstacles. To improve on current tools, a novel multi-articulated endoscope (MAE) is currently under development. To investigate its feasibility and possible value, we performed a user test using virtual prototype of the MAE with the intent to show that it outperforms the conventional endoscope while bringing minimal additional burden to the operator.
Methods
To evaluate the prototype, we built a virtual model of the MAE and a rigid oblique-viewing endoscope. Through a comparative user study we evaluate the ability of each device to visualize certain targets placed inside the virtual chest cavity by the angle between the visual axis of the scope and the normal of the plane of the target, while accounting for the usability of each endoscope by recording the time taken for each task. In addition, we collected a questionnaire from each participant to obtain feedback.
Results
The angles obtained using the MAE were smaller on average (\(p = 0.01, \text {MD} = 7.25\)), indicating that better visualization can be achieved through the proposed method. A nonsignificant difference in mean time taken for each task in favor of the rigid endoscope was also found (\(p = 0.42, \text {MD} = -2.09\)).
Conclusions
We have demonstrated that better visualization for endoscopic surgery can be achieved through our novel MAE. The scope may bring about a paradigm shift in the field of minimally invasive surgery by providing more freedom in viewpoint selection, enabling surgeons to perform more elaborate procedures in minimally invasive settings.
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The research was funded by a grant from the Advanced Science, Technology and Management Research Institute/Kyoto city fund for the promotion of medical industry through support for research and small-to-medium sized enterprises.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Karvonen, T., Muranishi, Y., Yamamoto, G. et al. Evaluation of a novel multi-articulated endoscope: proof of concept through a virtual simulation. Int J CARS 12, 1123–1130 (2017). https://doi.org/10.1007/s11548-017-1599-0
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DOI: https://doi.org/10.1007/s11548-017-1599-0