Background

Laparoscopy has enjoyed improvements over the last three decades primarily in achieving high definition, but the 70° field of view (FOV) remains unchanged. Complications related to events that take place out of the FOV continue to be reported. Additional problems leading to poor visualization are fogging and smoke accumulation. A novel laparoscopic system (SurroundScope, 270Surgical) was developed and dramatically expands the FOV from the 70° to 270° by adding side cameras at the distal tip of the laparoscope, while LED illumination eliminates fogging and improves smoke effects. This study describes the initial clinical experience with SurroundScope and its potential advantages over traditional laparoscopy.

Methods

SurroundScope was studied at Bnai Zion Medical Center in Israel and the Minnesota Institute for Minimally Invasive Surgery in America. 27 laparoscopic surgeries were performed, and at the end of each procedure, evaluations were completed by all surgeons and camera holders.

Results

All 27 cases were completed successfully without adverse events. No injuries occurred as a result of surgical tool manipulation outside of the central frame while 133 potentially adverse events were identified on side frames. There was no fogging across the 27 cases. The impact of smoke was negligible in all cases, as laparoscope removal or venting was never necessary. Surgeon respondents indicated that tools could be followed from the port to the site of surgery without camera manipulation. Most surgeons strongly agreed that the potential to identify bleeding was improved. Camera holders strongly agreed that the ergonomics were improved and that they moved the camera less than with a standard laparoscope.

Conclusions

Initial results demonstrate numerous advantages for SurroundScope as compared to traditional laparoscopy. The important benefits of expanded FOV, complete lack of fogging, and negligible smoke may improve patient safety, reduce adverse events and the duration of surgery. Further investigation to quantify these benefits is recommended.

中文翻译：

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通过新型腹腔镜摄像系统引入广角 270° 腹腔镜

背景

在过去的 30 年中，腹腔镜检查取得了进步，主要是在实现高清晰度方面，但 70° 视野 (FOV) 保持不变。继续报告与 FOV 外发生的事件相关的并发症。导致不良可视化的其他问题是起雾和烟雾堆积。开发了一种新型腹腔镜系统（SurroundScope，270Surgical），通过在腹腔镜远端添加侧摄像头，将 FOV 从 70° 显着扩大到 270°，同时 LED 照明消除了雾化并改善了烟雾效果。本研究描述了 SurroundScope 的初步临床经验及其相对于传统腹腔镜检查的潜在优势。

方法

SurroundScope 在以色列的 Bnai Zion 医疗中心和美国的明尼苏达微创外科研究所进行了研究。进行了 27 次腹腔镜手术，每次手术结束时，所有外科医生和相机支架都完成了评估。

结果

27例均顺利完成，无不良事件。中央框架外的手术工具操作未发生任何伤害，而在侧框架上发现了 133 起潜在的不良事件。27个病例没有起雾。在所有情况下，烟雾的影响都可以忽略不计，因为从不需要腹腔镜取出或排气。外科医生受访者表示，无需操作摄像头即可从端口跟踪工具到手术部位。大多数外科医生强烈同意识别出血的可能性有所提高。相机持有者强烈同意人体工程学得到了改进，并且他们移动相机的次数少于标准腹腔镜。

结论

初步结果表明，与传统腹腔镜相比，SurroundScope 具有众多优势。扩大 FOV、完全没有雾化和可忽略的烟雾的重要好处可以提高患者的安全性，减少不良事件和手术时间。建议进一步调查以量化这些好处。