Enhanced Laparoscopic Vision Improves Detection of Intraoperative Adverse Events During Laparoscopy

Background: The absence of visibility of the entire surgical scene in laparoscopic surgery can lead to unforeseen intraoperative complications. An Enhanced Laparoscopy Vision System (ELViS) was developed to eliminate the blind spots of the traditional endoscope by providing a broad view of the surgical scene from a distance, thanks to two additional images. This study assessed whether the broad view provided by the Enhanced Laparoscopic Vision (ELV) helped the surgeon to detect and react to an unexpected intraoperative adverse event (simulated hemorrhage) occurring while performing a standard task. Methods: While participants were performing a standard task (sorting pins) on a dry lab laparoscopic simulator with or without ELV, a simulated bleeding (LED lighting) was randomly triggered. Per-procedure metrics were recorded and surgeons' feedback gathered at the end of the session. Results: Thirteen Senior surgeons participated. Mean response time was significantly reduced when using ELV, with a similar number of simulated bleeding events between both modalities. All surgeons agreed that ELV could be helpful and constitutes an acceptable increase in cognitive load. Conclusion: In a dry lab setup, compared to traditional endoscopy, the broader field of view provided by ELV improved outcomes when dealing with unforeseen complications like bleeding. (c) 2020 AGBM. Published by Elsevier Masson SAS. All rights reserved.