1. During the laparoscopic gynecological procedures, a laparoscope is used to operate on uterus and/or Fallopian tubes and/or ovaries. Laparoscopic surgery has many advantages over open surgery - it minimizes tissue trauma, shortens recovery time and reduces length of hospital stay. However, it presents considerable challenges for surgeons, such as distorted haptic feedback from long stemmed instruments (laparoscopes, graspers & dissectors). Compared to open surgery, higher injury rates have been documented in laparoscopic surgery. Surgeons have learnt to adapt to reduced haptic feedback by relying on 2D visual live imagery to make decisions and complete procedures.
2. Laparoscopy procedures usually require 6 to 8 hands to accomplish multiple tasks during the 90-120 minute time frame. This increases the surgeon’s dependency on other actors in OR to accomplish a safe and successful procedure. E.g. to handle the fluid management & imaging systems, track the patient vitals and operate electrocautery laser device etc. the surgeon requires one person assigned to each capital device. Monitoring devices, surgical & therapeutic devices, and information systems are all disjointed and disconnected. These technologies have entered surgical practice in tandem and they all operate on different platforms. In addition to the surgical procedure itself, surgeons now need to focus on parameters of these devices that are assisting surgery.
1. An intelligent interface can be accomplished by use of ubiquitous sensors (light, proximity, ultrasound sensors etc.) which are implanted in the multiple devices and surgical instruments. E.g. A sensor at the distal tip of the laparoscope could provide the surgeon with guidance on location of the target site during the initial phase of hysterectomy. This can also be assisted by a photochemical solution which may be used to provide the surgeon a visual guide of the locations of the arteries while dissecting to ensure minimal blood loss and injuries to the patient. This will enable a smart layer of information over the existing 2D video feed, to enhance the surgeon’s decision making abilities.
This will also enhance the haptic feedback and depth of perception for the surgeon to enable better guidance for equipment like graspers, dissectors, electrodes; to perform hemostasis. This is enabled by the use of a layer of intelligence driven by sensors and secondary image processing.
2. To reduce the complexity which occurs due to the tandem operation and use of capital devices, surgical instruments and other resources in the OR, there is an immediate and critical need to build an intelligent interface via capital device integration. Such a connected application platform solution, receives live images/video feed from the laparoscopic camera, multiple live parameters such as CO2 insufflator settings/control, electrocautery device settings/control, patient vitals and anesthesia parameters from respective monitoring devices and patient information data from HIS, PACS, EMR etc. These are processed through the gateway controller unit which contains a hardware controller to make it compatible for display on a common platform. The solution uses secondary image processing to aid the surgeon in making better decisions with help of an intelligent layer of information aided by a smart GUI. This will allow a seamless ecosystem of multiple devices on a single point application, reduce the number of actors required in the OR and enable the surgeon to manage all devices with ease. E.g. Surgeon would be able to change the CO2 gas settings such as gas flow rate, volume etc. to maintain the gas pressure below the critical levels ensuring a clear visibility at the same time to navigate to the target site, along with monitoring total procedure time, documenting critical scenarios and abnormalities.
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