Robotics versus human golden fingers in gynaecological endoscopy

The objective of the study was to compare the traditional vaginal laparotomy and radical hysterectomy techniques with different kinds of endoscopically assisted or total endoscopic hysterectomy techniques. The golden fingers used in vaginal surgery and at laparotomy are assisted in endoscopic surgery by instruments without tactile feeling but dependent upon the subjective course movements and intelligent fingers of the surgeon. Computerised documentation has gained ground in gynaecological endoscopy and even robots no longer belong just in the realm of science fiction but perform specialised tasks in certain fields. The aim of this study was a comparison of robotic versus human laparoscopic camera control in GO cases of laparoscopic assisted vaginal hysterectomy. Methods: Utilising robotic technology a robot: has been designed specifically for the purpose of holding and manoeuvring the laparoscope under the direct control of the surgeon, We tested AESOP 3000 = Automated Endoscopic System for Optimal Positioning in 45 patients who underwent a classic intrafascial supracervical hysterectomy and in 15 patients under going routine laparoscopic assisted vaginal hysterectomies (LAVH). Results: The elimination of the camera holder allows two doctors to perform complex laparoscopic surgery faster than without the robotic arm. The average length of the hysterectomy procedure performed by surgeons using the AESOP voice control was 50 minutes for the CISH technique and 70 minutes for the LAVH. The length of the surgical procedures was compared to similar operations without the AESOP support ann and revealed a time save of at least 15 minutes. Conclusion: The voice-controlled AESOP also works in hysterectomy procedures more efficiently and faster than the hand or foot control of the same device and certainly faster than a camera held by an assistant. Human golden fingers employed only to hold a camera in gynaecological surgery are better replaced by robotic control. I envisage tactile instruments working together with robotic camera control in an ideal way in the forthcoming millennium.