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The 3-Dimensional Insect Eye Laparoscopic Imaging System - Evaluation of a Novel Technology by a Prospective Randomized Study Y. Kaufman, A. Sharon, O.

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Presentation on theme: "The 3-Dimensional Insect Eye Laparoscopic Imaging System - Evaluation of a Novel Technology by a Prospective Randomized Study Y. Kaufman, A. Sharon, O."— Presentation transcript:

1 The 3-Dimensional Insect Eye Laparoscopic Imaging System - Evaluation of a Novel Technology by a Prospective Randomized Study Y. Kaufman, A. Sharon, O. Klein, D Spiegel, R. Oslander and A. Lissak The Lady Davis Carmel Medical Center, Haifa, Israel

2 Minimally Invasive Surgery (MIS) – Time to improve 1. Safety 2. Cost 3. Operative durations 4. Learning curve 5. Future applications ?!

3 Handicaps of laparoscopic surgery No direct visualization Loss of haptic (active touch) perception Movements of instruments is restricted – based on a fixed pivot point on the abdominal wall Information for performing 3-D movements is received on a 2-D monitor

4 Depth perception MONOCULAR CUES

5 Depth illusion

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7 Error types: – Perceptual input data (visual/haptic): Surgeon had deliberately cut a duct thought to be a different duct Surgeon injured an unseen duct – Knowledge & decision making: Unorthodox strategy of surgery Performed an operation in an inappropriate setting – Action (technical skill) Way LW, Stewart L, Gantert W. et al. Causes and Prevention of Laparoscopic Bile Duct Injuries. Annals of Surgery, 2003 27(4) 460-9

8 97% Way LW, Stewart L, Gantert W. et al. Causes and Prevention of Laparoscopic Bile Duct Injuries. Annals of Surgery, 2003 27(4) 460-9

9 Z lag – Aligning X and Y axes before moving in the depth Z axis

10 Monocular cues Optical illusions Erroneous movements Accidents Decreased accuracy of movements More ballistic correctional sub- movements Longer operations Z lag - Aligning on the X and Y axes before moving in the depth Z axis Longer operations & smeared learning curves

11 3D Laparoscopic Imaging Systems Reduce: – Number of movements – Total distance of movements – Surgery duration 40-50% Taffinder N, Smith SG, Huber J, et al. The effect of a second-generation 3D endoscope on the laparoscopic precision of novices and experienced surgeons. Surgical Endoscopy, 1999. 13(11): 1087-92

12 Second generation imaging systems Images are different not only in angle but in color, optical distortion and sharpness Fatigue, headache, nausea, dizziness, eye strain

13 Insect eye technology Single video chip with 100,000s tiny eyes (pixels) embedded in 3x3 mm chip Many small, slightly distorted images image processing computer Images divided into left & right according to a specialized algorithm

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15 Research with the Insect eye technology University of Bologna, Italy Lahey Clinic, Boston, USA Sheba Medical Center, Israel Ichilov Medical Center, Israel Carmel Medical Center, Israel

16 Benefits using the Insect eye technology Reduction in operative time for experienced as well as novice surgeons Shorter learning curve Greater satisfaction reported by the surgeon No side effects

17 3-D2-D Operation type \ Imaging system Δn95% CISDMeann95% CISDMean -12.2% 831.5-49.312.8 40.4 929.6-62.425.1 46 BSO (n=17) -38.7% 525.1-52.115.4 38.6 33.7-122.352.4 63 USO (n=8) -57.1% 25.1-12.92.8 9 413.7-28.37.5 21 BTL (n=6) -25.9% 821.2-4819.3 34.6 835.7-57.715.9 46.7 Cystectomy (n=16) -13.7% 1218-29.810.4 23.9 922.7-32.77.6 27.7 Diagnostic laparoscopy (n=21) Table 1: Surgery duration in minutes according to the type of operation and the type of imaging system used +28.3% 485.5-144.930.3 115 569.3-110.323.4 89.8 STLH (n=9) +5.1% 473.1-108.317 90.7 775.4-97.214.7 86.3 STLH + BSO (n=11)

18 Figure 1: Surgery duration in minutes according to the experience of the surgeon and the type of imaging system used. (n = number of subjects in each group)

19 Figure 2: Amount of blood loss (in cc) according to the level of difficulty as estimated by the surgeon and to the type of imaging system used. (n = number of subjects in each group)

20 Figure 3: surgeon satisfaction criteria using the 2-D vs. 3-D imaging systems (1=Insufficient, 2=Sufficient, 3=Excellent)

21 Benefits using the Insect eye technology Reduction in operative time for experienced as well as novice surgeons Shorter learning curve Greater satisfaction reported by the surgeon No side effects Decreased operative durations found mostly in shorter operative procedures

22 More possible benefits Advanced performance surgery – lymph node dissection Narrow operative fields Integration with other imaging modalities – CT image reconstruction – Intra-abdominal 3D + 4D US – See through the tissue

23 Y. Kaufman M.D ¹., A. Sharon M.D. ¹., O. Klein M.D. ¹., D Spiegel M.D. ², R. Auslander, M.D. ¹. and A. Lissak M.D. ¹. The 3-Dimensional Insect Eye Laparoscopic Imaging System - Evaluation of a Novel Technology by a Prospective Randomized Study


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