'Multi-joint laparoscopic instruments' to demonstrate reduced operation time and improved efficiency
Nov 25, 2024
A research team led by Professor Oh Heung-kwon (corresponding author) and Professor Shin Hye-rim (first author) of surgery at Seoul National University Bundang Hospital has published research results demonstrating that in laparoscopic colon surgery, 'multi-joint laparoscopic instrument' can increase the operator's depth perception ability and improve efficiency compared to conventional fixed surgical instruments, thereby shortening surgery time and improving surgical performance.
During laparoscopic surgery of the large intestine, various manipulations should be performed with surgical instruments in a narrow space in the patient's body. Existing fixed surgical instruments have been pointed out as limitations in efficiency and accuracy in the surgical process because they move only in a single direction, making it difficult to secure the operator's field of view and process it accurately.
Accordingly, multi-joint laparoscopic instruments were introduced. The device is known to provide free movement even in a narrow space in the body as it can be operated in various directions with a multi-joint design that mimics the movement of the human wrist.
The research team conducted a study on 70 patients undergoing laparoscopic surgery such as colon cancer to see how much the multi-joint laparoscopic instrument can improve effectiveness and safety in laparoscopic surgery of the large intestine compared to conventional fixed surgical instruments. Surgical performance was evaluated by categorizing it into a patient group (20 patients) using a fixed instrument and a patient group (50 patients) using a multi-joint laparoscopic instrument.
Evaluation was done through surgical video analysis and the Global Laparoscopic Surgical Technology Evaluation Tool (mGOALS). mGOALS is an indicator that systematically and objectively measures surgical performance as it can evaluate four key areas: depth perception, two-hand technique, efficiency, and tissue processing. Performance in the Experienced Phase was also compared and analyzed. It is a method of checking the proficiency of instrument operation through a learning curve after accumulating experience with instruments. In addition, the time of surgery, amount of bleeding, length of hospital stay, and the incidence of postoperative complications were additionally analyzed.
As a result of the study, the operation time was shortened by about 34 minutes and the amount of bleeding during the operation was reduced by about half. In particular, there was a significant improvement over fixed instruments in the group using multi-joint laparoscopic instruments in terms of dealing with tissues and recognizing depth, meaning that multi-joint laparoscopic instruments can increase operability of the operator and enable accurate field of view and precise manipulation during surgery, thereby increasing surgical performance.
In addition, in the experience accumulation stage, it was confirmed that the surgical performance continued to improve as the medical staff gained skill level, and it was found that the operator could achieve sufficient skill level with only about 10 uses. This suggests that the use of multi-joint laparoscopic instruments can be quickly adapted without much learning burden.
The results of this study are the first to verify the effectiveness and stability of multi-joint laparoscopic surgical instruments in laparoscopic colon surgery, and it is meaningful to discover the possibility that multi-joint laparoscopic surgical instruments can increase the efficiency of colon surgery and positively affect the recovery speed of patients.
Professor Oh Heung-kwon of surgery at Seoul National University Bundang Hospital said, `The multi-joint laparoscopic surgical instrument is expected to be widely used in various medical fields in the future as it provides a similar level of multi-directional operation compared to robotic surgery.'"We plan to conduct research to verify the effectiveness of multi-joint laparoscopic instruments in other complex surgeries in the future to secure more clinical evidence."
This study was carried out with the support of the Health Industry Promotion Agency's demonstration support project for innovative medical devices and was published in the European Journal of Anastomotic Surgery in October 2024. 논문명은 'Comparison of surgical performance using articulated(ArtiSential) and conventional instruments for colorectal laparoscopic surgery: A single-centre, open, before-and-after, prospective study'이다.
During laparoscopic surgery of the large intestine, various manipulations should be performed with surgical instruments in a narrow space in the patient's body. Existing fixed surgical instruments have been pointed out as limitations in efficiency and accuracy in the surgical process because they move only in a single direction, making it difficult to secure the operator's field of view and process it accurately.
Accordingly, multi-joint laparoscopic instruments were introduced. The device is known to provide free movement even in a narrow space in the body as it can be operated in various directions with a multi-joint design that mimics the movement of the human wrist.
The research team conducted a study on 70 patients undergoing laparoscopic surgery such as colon cancer to see how much the multi-joint laparoscopic instrument can improve effectiveness and safety in laparoscopic surgery of the large intestine compared to conventional fixed surgical instruments. Surgical performance was evaluated by categorizing it into a patient group (20 patients) using a fixed instrument and a patient group (50 patients) using a multi-joint laparoscopic instrument.
Evaluation was done through surgical video analysis and the Global Laparoscopic Surgical Technology Evaluation Tool (mGOALS). mGOALS is an indicator that systematically and objectively measures surgical performance as it can evaluate four key areas: depth perception, two-hand technique, efficiency, and tissue processing. Performance in the Experienced Phase was also compared and analyzed. It is a method of checking the proficiency of instrument operation through a learning curve after accumulating experience with instruments. In addition, the time of surgery, amount of bleeding, length of hospital stay, and the incidence of postoperative complications were additionally analyzed.
As a result of the study, the operation time was shortened by about 34 minutes and the amount of bleeding during the operation was reduced by about half. In particular, there was a significant improvement over fixed instruments in the group using multi-joint laparoscopic instruments in terms of dealing with tissues and recognizing depth, meaning that multi-joint laparoscopic instruments can increase operability of the operator and enable accurate field of view and precise manipulation during surgery, thereby increasing surgical performance.
In addition, in the experience accumulation stage, it was confirmed that the surgical performance continued to improve as the medical staff gained skill level, and it was found that the operator could achieve sufficient skill level with only about 10 uses. This suggests that the use of multi-joint laparoscopic instruments can be quickly adapted without much learning burden.
The results of this study are the first to verify the effectiveness and stability of multi-joint laparoscopic surgical instruments in laparoscopic colon surgery, and it is meaningful to discover the possibility that multi-joint laparoscopic surgical instruments can increase the efficiency of colon surgery and positively affect the recovery speed of patients.
Professor Oh Heung-kwon of surgery at Seoul National University Bundang Hospital said, `The multi-joint laparoscopic surgical instrument is expected to be widely used in various medical fields in the future as it provides a similar level of multi-directional operation compared to robotic surgery.'"We plan to conduct research to verify the effectiveness of multi-joint laparoscopic instruments in other complex surgeries in the future to secure more clinical evidence."
This study was carried out with the support of the Health Industry Promotion Agency's demonstration support project for innovative medical devices and was published in the European Journal of Anastomotic Surgery in October 2024. 논문명은 'Comparison of surgical performance using articulated(ArtiSential) and conventional instruments for colorectal laparoscopic surgery: A single-centre, open, before-and-after, prospective study'이다.
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