Yuki Ushimaru1,2, Tsuyoshi Takahashi2, Yoshihito Souma3, Yoshitomo Yanagimoto4, Hirotsugu Nagase5, Koji Tanaka2, Yasuhiro Miyazaki2, Tomoki Makino2, Yukinori Kurokawa2, Makoto Yamasaki2, Masaki Mori2, Yuichiro Doki2, Kiyokazu Nakajima6,7. 1. Division of Next Generation Endoscopic Intervention (Project ENGINE), Osaka University Graduate School of Medicine, Osaka, Japan. 2. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. 3. Department of Gastroenterological Surgery, Kenporen Osaka Central Hospital, Osaka, Japan. 4. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan. 5. Department of Gastroenterological Surgery, Toyonaka Municipal Hospital, Osaka, Japan. 6. Division of Next Generation Endoscopic Intervention (Project ENGINE), Osaka University Graduate School of Medicine, Osaka, Japan. knakajima@gesurg.med.osaka-u.ac.jp. 7. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. knakajima@gesurg.med.osaka-u.ac.jp.
Abstract
BACKGROUND: With the improvement of sensor technology, the trend of Internet of Things (IoT) is affecting the medical devices. The aim of this study is to verify whether it is possible to "visualize instrument usage in specific procedures" by automatically accumulating the digital data related to the behavior of surgical instruments/forceps in laparoscopic surgery. METHODS: Five board-certified surgeons (PGY 9-24 years) performed laparoscopic cholecystectomy on 35-kg porcine (n = 5). Radio frequency identifier (RFID) was attached to each forceps with RFID readers installed on the left/right of the operating table. We automatically recorded the behavior by tracking the operator's right/left hands' forceps with RFID. The output sensor was installed in the electrocautery circuit for automatic recordings of the ON/OFF times and the activation time. All data were collected in dedicated software and used for analysis. RESULTS: In all cases, the behaviors of forceps and electrocautery were successfully recorded. The median operation time was 1828 s (range 1159-2962 s), of which the electrocautery probe was the longest held on the right hand (1179 s, 75%), followed by Maryland dissectors (149 s, 10%), then clip appliers (91 s, 2%). In contrast, grasping forceps were mainly used in the left hand (1780 s, 93%). The activation time of electrocautery was only 8% of the total use and the remaining was mainly used for dissection. These situations were seen in common by all operators, but as a mentor surgeon, there was a tendency to change the right hand's instruments more frequently. The median activation time of electrocautery was 0.41 s, and these were confirmed to be 0.14-0.57 s among the operators. CONCLUSION: By utilization of IoT for surgery, surgical procedure could be "visualized." This will improve the safety on surgery such as optimal usage of surgical devices, proper use of electrocautery, and standardization of the surgical procedures.
BACKGROUND: With the improvement of sensor technology, the trend of Internet of Things (IoT) is affecting the medical devices. The aim of this study is to verify whether it is possible to "visualize instrument usage in specific procedures" by automatically accumulating the digital data related to the behavior of surgical instruments/forceps in laparoscopic surgery. METHODS: Five board-certified surgeons (PGY 9-24 years) performed laparoscopic cholecystectomy on 35-kg porcine (n = 5). Radio frequency identifier (RFID) was attached to each forceps with RFID readers installed on the left/right of the operating table. We automatically recorded the behavior by tracking the operator's right/left hands' forceps with RFID. The output sensor was installed in the electrocautery circuit for automatic recordings of the ON/OFF times and the activation time. All data were collected in dedicated software and used for analysis. RESULTS: In all cases, the behaviors of forceps and electrocautery were successfully recorded. The median operation time was 1828 s (range 1159-2962 s), of which the electrocautery probe was the longest held on the right hand (1179 s, 75%), followed by Maryland dissectors (149 s, 10%), then clip appliers (91 s, 2%). In contrast, grasping forceps were mainly used in the left hand (1780 s, 93%). The activation time of electrocautery was only 8% of the total use and the remaining was mainly used for dissection. These situations were seen in common by all operators, but as a mentor surgeon, there was a tendency to change the right hand's instruments more frequently. The median activation time of electrocautery was 0.41 s, and these were confirmed to be 0.14-0.57 s among the operators. CONCLUSION: By utilization of IoT for surgery, surgical procedure could be "visualized." This will improve the safety on surgery such as optimal usage of surgical devices, proper use of electrocautery, and standardization of the surgical procedures.
Keywords:
Information communication technology; Internet of Things; Laparoscopic cholecystectomy; RFID; Tracking
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