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      Preliminary results of using a voice-controlled robotic camera driver during 3D laparoscopic radical prostatectomy

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          Abstract

          Introduction

          During laparoscopic procedures, the surgeon's control on target field visualization as well as optimal and steady vision can be achieved by using a camera holder. The article presents our preliminary experience with the use of a voice controlled robotic camera holder during 3D laparoscopic radical prostatectomy (3D LRP).

          Material and method

          Thirty patients were prospectively enrolled and underwent either 3D LRP with the use of a voice controlled robotic camera holder (study group) or 3D LRP with the surgeon holding the camera (control group). Oncological, demographic data and surgical parameters were evaluated.

          Results

          Voice-controlled 3D LPR produces a more stable visual field that subjectively decreases the surgeon's fatigue, enables precise preparation, especially along big vessels during lymphadenectomy, urethral stump preparation and urethro-vesical anastomosis. In the fifteen cases analyzed, voice-controlled 3D LRP saved 47 hours of surgeon's time.

          Conclusions

          In this study, the preliminary experience with a robotic arm for camera positioning revealed that the positioner is effective, easy to use and provides a steady and reliable visual field for laparoscopic urological procedures.

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          Most cited references8

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          Comparison of robotic versus human laparoscopic camera control .

          We investigated the accuracy and use of a robotic surgical arm compared to a human surgical assistant during urological laparoscopic surgery. A total of 11 patients undergoing pelvic laparoscopic procedures that required identical bilateral surgical manipulations was evaluated. On 1 side a robotic surgical arm was used to manipulate the laparoscopic camera, while on the contralateral side the camera was positioned by a human surgical assistant. The side (left versus right) on which the robot was used was alternated with each case. Parameters assessed included operative time, erroneous camera motions, complications and outcome. All procedures were successfully completed without complications. Laparoscopic camera positioning was significantly steadier with less inadvertent movements when under robotic control (p < 0.0005). Operative times during dissections using the robot or human assistant were not statistically different. A robotic device can more effectively manipulate and accurately control the video endoscope than a human assistant during laparoscopic procedures.
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            Comparison of surgical performance during laparoscopic radical prostatectomy of two robotic camera holders, EndoAssist and AESOP: a pilot study.

            Robotic camera holders provide steady camera movement and view during laparoscopic surgery. We compared two such robots, EndoAssist and AESOP, by evaluating timed setup and surgical performance during laparoscopic radical prostatectomy (LRP). We prospectively collected data for 20 patients undergoing LRP using either the EndoAssist or AESOP. AESOP was mounted to the surgical bed and controlled by an experienced assistant using a hand-held remote control. The EndoAssist device was placed over the patient's right shoulder. Its movements were executed by the surgeon using a head-mounted optical emitter with brief head movements detected by a sensor mounted atop the surgeon's video monitor. The robot setup time and LRP operative steps were timed and compared between the two cohorts. The time for robot setup favored AESOP over the EndoAssist (2.0 minutes versus 5.3 minutes, P = 0.001). The time for accomplishing vas deferens and seminal vesicle dissection favored the EndoAssist (23 minutes versus 33 minutes, P = 0.04). However, no statistically significant difference was found in the efficiency of task performance between the two robots in any of the other 11 steps measured. The EndoAssist appears to be equally efficient to the assistant-controlled AESOP robot with respect to surgical performance during LRP. The advantages of the EndoAssist include its accurate response and ability to provide the surgeon with complete control of the desired operative view without relying on an assistant. Its disadvantages include its large profile, lack of a table-mounted design, and the need for pedal activation. Additional modifications are needed to improve the efficiency and design of this novel robotic device further.
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              The Australian laparoscopic non robotic radical prostatectomy experience - analysis of 2943 cases (USANZ supplement).

              To analyse the Australian experience of high-volume Fellowship-trained Laparoscopic Radical Prostatectomy (LRP) surgeons.
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                Author and article information

                Journal
                Cent European J Urol
                Cent European J Urol
                CEJU
                Central European Journal of Urology
                Polish Urological Association
                2080-4806
                2080-4873
                27 December 2018
                2018
                : 71
                : 4
                : 394-398
                Affiliations
                [1 ]Department of Urology and Oncological Urology, Mazovian Regional Hospital, Siedlce, Poland
                [2 ]Department of Urology, The Faculty of Medicine and Health Sciences, University of Zielona Góra, Zielona Góra, Poland
                Author notes
                Corresponding author Maciej Salagierski, University of Zielona Góra, The Faculty of Medicine and Health Sciences, Department of Urology, 28 Zyty Street, 65-046 Zielona Góra, Poland. m.salagierski@ 123456wlnz.uz.zgora.pl
                Article
                1800
                10.5173/ceju.2018.1800
                6338813
                e875d7a9-caa6-40c5-956f-eb7a91a08604
                Copyright by Polish Urological Association

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                History
                : 05 October 2018
                : 27 November 2018
                : 04 December 2018
                Categories
                Original Paper

                3d laparoscopic prostatectomy,prostate cancer,voice-controlled robotic camera

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