Identification of the optimal visual recording system in open abdominal surgery - a prospective observational study

摘要

Introduction: Current methodologies used to record and render the surgeon's point of view in open operative surgery remain limited. Chief among these limitations is a failure to demonstrate, in high definition and magnification, the planar roadmap that surgeons utilise in colorectal surgery. The high magnification and high resolution views provided during laparo-scopic surgery simultaneously capture the planar road map and surgeon's point of view. We developed an arm-mounted external laparoscope (exoscope) system and compared its performance against multiple standard recording modalities. Methods: Following ethical approval and informed consent, open colorectal procedures were recorded using five separate methodologies. Each methodology was assessed and compared. Results: Most of the methodologies utilised scored poorly at one if not more levels. The arm-mounted external laparoscope (exoscope) scored highest in rendering the surgeon's point of view while simultaneously achieving high resolution and high magnification rendition of operative field (p< .001). This methodology was tested in a number of operative contexts within which it reproducibly and consistently scored highly. Conclusions: The arm-mounted exoscope is the optimal means of rendering the surgeon's point of view of anatomic planes during open colorectal surgery.