Laparoscopic cholecystectomy performed by a single surgeon using a visual field tracking camera - Early experience

Background: This report describes a visual field tracking camera for laparo scopic surgery that allows the visual field to be changed without moving th e laparoscope. We also report on our early experience with this camera for single-surgeon laparoscopic cholecystectomy. Methods: The visual field tracking camera has a tracking mechanism (compose d of a zoom lens and a charge-coupled device [CCD] slide mechanism) built i nto the camera head. The 80 degrees visual field observed with the laparosc ope can be expanded using the zoom lens, and the field can be shifted by ch anging the size of the area being viewed by the CCD. This is accomplished b y pushing a switch on the forceps or by verbal command. Cholecystectomy was carried out on 12 patients with gallstones using this camera. The operatio ns were performed by either a single surgeon or two surgeons. Forceps held with a forceps holder were inserted through the right port to lift the fund us of the gallbladder. The single surgeon used the other two ports to resec t the gallbladder by the two-handed technique. Results: In all cases, cholecystectomy was completed without any need to mo ve the laparoscope at any point during the operation. Seven operations were performed by a single surgeon. Mainly for education purposes, five other o perations were performed by a pair of surgeons. The mean time required for surgery was 76 +/- 17 min. This time did not differ from that of laparoscop ic cholecystectomy performed during the same period on 22 patients by teams of three surgeons using conventional cameras. Conclusions: Using the visual field tracking camera, laparoscopic cholecyst ectomy can be performed without any need to touch the laparoscope. This cam era allowed laparoscopic cholecystectomy to be performed by a single surgeo n.