Robotic Endoscope Control - State of the Art of Voice Control and Other Options for Laparoscopic Camera Robot Guidance.

Abstract

In video-based surgery (VBS), the surgeon is no longer the master of his or her view. Visualization of the surgical field is mediated by a video camera guided by an assistant. The separation of visualization and surgical activities leads to significant drawbacks. Early in the history of VBS, active camera holders controlled directly by the surgeon were introduced to replace the human camera assistant. However, despite remarkable technological advances over the past 25 years, robotic camera guidance systems (RCGS) still play only a marginal role. This is less due to inadequate mechanical designs or kinematics, and mainly due to inadequate human-machine interaction. In most cases, a simple task-shift is required that increases the surgeon's mental workload instead of reducing it. The current state of the art in robotic camera guidance, as represented by the SOLOASSIST II RCGS (AKTORmed, Neutraubling, Germany), includes a sophisticated combination of direct manual control, joystick navigation and high-quality voice control that provides the most intuitive surgeon-machine interaction currently available. An in-depth analysis of further clinical needs and promising developments in operating room integration suggests that the addition of context sensitivity could actually enhance the assistive effect of RCGS, making them potentially superior to the average human camera guidance.