OPTIMAL PORT LOCATIONS FOR ENDOSCOPIC INTRACORPOREAL KNOTTING

Port location is crucial for endoscopic manipulations. The aim of the study was to investigate the influence of manipulation, azimuth, and e levation angles of instruments on endoscopic intracorporeal knotting. The standard task was tying a surgeon's knot. Manipulation angles of 3 0 degrees, 45 degrees, 60 degrees, 75 degrees, and 90 degrees with equ al and unequal azimuth angles and elevation angles of 0 degrees, 30 de grees, and 60 degrees were investigated. The endpoints were the execut ion time and parameters of knot analysis. The execution time was short er with 60 degrees than with either 90 degrees or 30 degrees manipulat ion angles (p < 0.0001 and p < 0.01). Equal azimuth angles resulted in a shorter execution time than wide unequal angles (p < 0.001). A comb ination of 60 degrees manipulation angle with 60 degrees elevation ang le had the shortest execution time (p < 0.001) and highest performance quality score (p < 0.02). A range of 45 degrees-75 degrees manipulati on angles with equal azimuth angles is recommended. As the manipulatio n angle increases, the elevation angle has to increase accordingly.