Ana Luisa Trejos1,2, Karen Siroen3, Christopher D W Ward3, Shahan Hossain4, Michael D Naish3,5, Rajni V Patel3,6, Christopher M Schlachta3,4. 1. Department of Electrical and Computer Engineering, University of Western Ontario, London, ON, Canada. atrejos@uwo.ca. 2. Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, 339 Windermere Road, London, ON, Canada. atrejos@uwo.ca. 3. Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, 339 Windermere Road, London, ON, Canada. 4. Department of Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada. 5. Department of Mechanical and Materials Engineering and Department of Electrical and Computer Engineering, The University of Western Ontario, London, ON, Canada. 6. Department of Electrical and Computer Engineering and Department of Surgery, University of Western Ontario, London, ON, Canada.
Abstract
INTRODUCTION: Training surgeons in minimally invasive surgery (MIS) requires surgical residents to operate under the direction of a consultant. The inability of the instructing surgeon to point at the laparoscopic monitor without releasing the instruments remains a barrier to effective instruction. The wireless hands-free surgical pointer (WHaSP) has been developed to aid instruction during MIS. METHODS: The objective of this study was to evaluate the effectiveness and likeability of the WHaSP as an instructional tool compared with the conventional methods. Data were successfully collected during 103 laparoscopic cholecystectomy procedures, which had been randomized to use or not use the WHaSP as a teaching tool. Audio and video from the surgeries were recorded and analyzed. Instructing surgeons, operating surgeons, and camera assistants provided feedback through a post-operative questionnaire that used a five-level Likert scale. The questionnaire results were analyzed using a Mann-Whitney U test. RESULTS: There were no negative effects on surgery completion time or instruction practice due to the use of the WHaSP. The number of times an instructor surgeon pointed to the laparoscopic screen with their hand was significantly reduced when the WHaSP was utilized (p < 0.001). The questionnaires showed that WHaSP users found it to be comfortable, easy to use, and easy to control. Compared to when the WHaSP was not used, users found that communication was more effective (p = 0.002), locations were easier to communicate (p < 0.001), and instructions were easier to follow (p = 0.005). CONCLUSIONS: The WHaSP system was successfully used in surgery. It integrated seamlessly into existing equipment within the operating room and did not affect flow. The positive outcomes of utilizing the WHaSP were improved communication in the OR, improved efficiency and safety of the surgery, easy to use, and comfortable to wear. The surgeons showed a preference for utilizing the WHaSP if given a choice.
RCT Entities:
INTRODUCTION: Training surgeons in minimally invasive surgery (MIS) requires surgical residents to operate under the direction of a consultant. The inability of the instructing surgeon to point at the laparoscopic monitor without releasing the instruments remains a barrier to effective instruction. The wireless hands-free surgical pointer (WHaSP) has been developed to aid instruction during MIS. METHODS: The objective of this study was to evaluate the effectiveness and likeability of the WHaSP as an instructional tool compared with the conventional methods. Data were successfully collected during 103 laparoscopic cholecystectomy procedures, which had been randomized to use or not use the WHaSP as a teaching tool. Audio and video from the surgeries were recorded and analyzed. Instructing surgeons, operating surgeons, and camera assistants provided feedback through a post-operative questionnaire that used a five-level Likert scale. The questionnaire results were analyzed using a Mann-Whitney U test. RESULTS: There were no negative effects on surgery completion time or instruction practice due to the use of the WHaSP. The number of times an instructor surgeon pointed to the laparoscopic screen with their hand was significantly reduced when the WHaSP was utilized (p < 0.001). The questionnaires showed that WHaSP users found it to be comfortable, easy to use, and easy to control. Compared to when the WHaSP was not used, users found that communication was more effective (p = 0.002), locations were easier to communicate (p < 0.001), and instructions were easier to follow (p = 0.005). CONCLUSIONS: The WHaSP system was successfully used in surgery. It integrated seamlessly into existing equipment within the operating room and did not affect flow. The positive outcomes of utilizing the WHaSP were improved communication in the OR, improved efficiency and safety of the surgery, easy to use, and comfortable to wear. The surgeons showed a preference for utilizing the WHaSP if given a choice.
Keywords:
Hands-free pointing; Instructing technology; Medical mechatronic systems; Surgical instruction
Authors: Barbara Goff; Lynn Mandel; Gretchen Lentz; Amy Vanblaricom; Anne-Marie Amies Oelschlager; David Lee; Andrew Galakatos; Matthew Davies; Peter Nielsen Journal: Am J Obstet Gynecol Date: 2005-04 Impact factor: 8.661