Page 5 - WALS Journal

Comparison of PMAT Camera Holder with Human Camera Holder

The surgeon noted:
1. The extent of body comfort and muscle fatigue, by using a
modified body part discomfort
2. Ease of scope movement or usability
3. Need to clean the telescope
4. Time of set-up the PMAT
5. Overall operative time
6. Surgical performance, and
A 7. Necessity to change the position and side of the table during
surgery
During all the procedure a thirty-degree Stortz laparoscope
was used. Camera of Maxer (Germany), and the Telescope
(Hanki sass Wolf) were used in surgery.

Results
All cases included in this study were free from any intraoperative
complications including major bleeding or other factors which
would have demanded additional hemostatic or reconstructive
steps. With regard to the extent of body comfort and muscle
fatigue, all three surgeons involved with the evaluation felt
comfortable with the PMAT for each of the laparoscopic
procedures studied, with no loss of autonomy. The surgeons
were slightly felt fatigue with use of the PMAT for laparoscopic
procedure which took more time, and prompting for motion
adjustment was required repeatedly for the cases studied. With
regard to ease of scope movement and the need to clean the
B
telescope, we found that, on average, the PMAT need more
time to disconnect the telescope. The time of set up was also
analyzed and overall set up time was more for PMAT than
human camera operator. The set-up time for all cases was under
5 min (graphic 1). With regard to surgical performance, all three
surgeons reported that the PMAT device did not compromise
surgical performance if co-axial alignment was maintained (Eye
of the surgeon, target of dissection and centre of the monitor in
same line). They also reported that the PMAT device was a
viable option which enabled optimum task performance for all
the types of case studied, and comparable with use of a human
camera driver. There were no significant differences between
complication rates or total operative time for procedures
conducted with the PMAT device or with a conventional human
assistant (Table 1), (Graphic 2). With regard to the need to
clean the scope, we found this was not a useful tool for
C measuring the performance of the PMAT because it varies from
case to case. Scope cleaning depends on several factors, e.g.
the assistant driving the camera, the body fat of the patient, the
Figs 3A to C: Movements: (A) right and left, (B) in and out,
(C) up and down. type of surgery being performed, temperature difference with
telescope and patient anatomy.
of the surgeon once the access is complete. Veress needle
technique was used for access in this study. All non-complicated Discussion
simple cases were selected for this study. Human camera operator
10
was kept in standby throughout the procedure during this study Kavoussi et al , in 1995 reported results of a study on the
so that in case of difficulty he can takeover of camera. accuracy and use of a robotic surgical arm compared with a

3