Development and First In Vivo Trial of EvoLap, an Active Laparoscope Positioner

Total Laparoscopic Hysterectomy with Pelvic/Aortic Lymph Node Dissection for Endometrial Cancer Using Passive Instrument Positioners: A Retrospective Case-Control Series

STUDY OBJECTIVE

To investigate the influence of the use of passive instrument positioners (PIPs) on laparoscopic operative outcomes for endometrial cancer relative to other independent variables.

DESIGN

Retrospective case-controlled study (Canadian Task Force classification II-2).

SETTING

Laparoscopies performed by the author in multiple community hospitals.

PATIENTS

A total of 297 consecutive patients between December 2009 and October 2016 with clinically isolated endometrial cancer or retroperitoneal lymphadenopathy on imaging studies.

INTERVENTIONS

Total laparoscopic hysterectomy with bilateral salpingo-oophorectomy and pelvic/aortic lymph node dissection using passive instrument positioners to secure the laparoscope (PIP group) and using instruments providing exposure and historical control by hand control of all instruments (HC group).

MEASUREMENTS AND MAIN RESULTS

The overall group mean age was 63.2 years (range, 32.4-90.9 years), and patient characteristics were equivalent in the 2 groups. In the PIP group, 1 procedure was converted to a laparotomy (0.5%), and in the HC group, 6 procedures were converted (5.4%; p = .008). The mean operative time was 140.1 minutes for the PIP group and 153.8 minutes for the HC group (p < .001). The mean length of hospital stay was 44.8 hours for the PIP group and 58.6 hours for the HC group (p < .001). Multivariate analysis confirmed that study group (PIP vs HC; p = .014) and the presence vs absence of metastatic disease (p = .001) influenced conversion; study group (PIP vs HC; p < .001), body mass index (p < .001), past surgical history (p = .010), and assistant training (p = .011) influenced operative time; and study group (PIP vs HC; p < .001), Eastern Cooperative Oncology Group performance status (p < .001), and operative time (p = .051) influenced hospital stay.

CONCLUSION

For clinically localized endometrial cancer managed laparoscopically, the use of PIPs reduces conversions, operative time, and hospital stay.

Laparoscopic Cholecystectomy with Freehand Laparoscopic Camera Controller

Introduction: Free hand laparoscopic camera controller (FHLCC) is a new innovative robotic device that has been recently implemented and adopted in laparoscopic surgery, providing the surgeon more comfort in carrying out his surgical skills without the difficulties related to the mutual understanding of the movements of the camera. Case presentation: We report the first case of laparoscopic cholecystectomy performed in our hospital with the aid of the free hand laparoscopic camera controller. Conclusion: Free hand laparoscopic camera controller provides the surgeon comfort in carrying out his surgical skills without the difficulties related to the mutual understanding of the movements of the camera. It combines the benefits of minimally invasive and robotic assisted surgery, increases efficiencies and improves patient recovery times.