J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 3649KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 100(4): 273-278, 1999

Feature topic

FUSION OF MEDICINE AND TECHNOLOGY IN ENDOSCOPIC SURGERY

1) Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
2) Department of System Design Engineering, Faculty of Science and Technology, Keio University, Tokyo, Japan

Masaki Kitajima1), Masahiro Ohgami1), Toshiharu Furukawa1), Yasuhide Morikawa1), Masahiko Watanabe1), Yuko Kitagawa1), Jo Tokuyama1), Kazuo Nakazawa2)

Although endoscopic surgery has become widespread and is currently used in a wide range of general, thoracic, urologic, gynecologic, and orthopedic procedures, many major difficulties remain because sensorial information is restricted to a two-dimensional image, and effector instruments have limited maneuverability due to the rigid shaft axis fixed to the abdominal wall by the entry trocar. To overcome these problems, advanced engineering technology has been introduced in laparoscopic surgery which includes three-dimensional video imaging, robotic laparoscopic cameraholders, telemarlipulated flexible effector instruments, and tactile feedback. A voice-controlied robotic laparoscopic holder (AESOP200, Computer Motion Inc, USA) provides stable support for the laparoscope during laparoscopic surgery performed by a single surgeon. A new computerassisted telemanipulation robot (lntuitive Surgical Inc. USA) permits the performance of completely endoscopic coronary artery bypass and Nissen fundoplication. Furthermore, price reductions and technological advances in telecommunications have made telementoring in endoscopic surgery available for routine clinical use, and intercontinental surgical video teleconferences fruitful opportunities for discussing technical details. The fusion of medicine and technology in endoscopic surgery would overcome difficulties in the conventional endoscopic approach.

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