Self-guided robotic camera control for laparoscopic surgery compared with human camera control

BACKGROUND: In laparoscopic surgery, the surgeon no longer has direct visua l control of the operation area, and a camera assistant who maneuvers the l aparoscope is essential. problems of cooperation between the two naturally arise, and a robotic assistant that automatically controls the laparoscope can offer a highly desirable alternative to this situation. METHODS: A self-guided robotic camera control system (SGRCCS) based upon a color tracking method has been developed and its use evaluated in 20 cases of laparoscopic cholecystectomy and compared with using human camera contro l. RESULTS: In 83% of the patients the procedures were successfully completed with the SGRCCS, Set-up time for the robot averaged 21 minutes; and the sur gical time with and without the robot averaged 54 and 60 minutes, respectiv ely. Using the robot instead of a human camera assistant significantly redu ced both the frequency of the camera correction, 2.2 per hour compared with 15.3 per hour, and frequency of the lens cleaning, 1.0 per hour compared w ith 6.8 per hour. Subjective assessment by the surgeon revealed that the ro bot performed better than the human assistant in 71% of the cases. CONCLUSIONS: In laparoscopic surgery, the SGRCCS offered optimal camera gui dance and helped to maintain the surgeon's concentration during the operati on. Am J Surg. 1999;177:321-324, (C) 1999 by Excerpta Medica, Inc.