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Rigid vs articulating instrumentation for task completion in single-port surgery.

Geoffrey Chow1, Chieh Jack Chiu1, Bin Zheng2

  • 1Department of Surgery, Division of General Surgery, University of British Columbia, 2775 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada.

American Journal of Surgery
|April 17, 2016
PubMed
Summary

Single-port access surgery (SPA) takes longer than conventional approaches. However, articulating instruments may offer benefits in SPA, despite initial longer task times.

Keywords:
Articulating instrumentationPerformance assessmentSimulationSingle-port access surgerySurgical education

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Technology

Background:

  • Single-port access surgery (SPA) offers potential benefits but presents a significant learning curve.
  • Comparison of traditional in-line instruments versus articulating instruments in SPA is crucial for understanding its adoption.

Purpose of the Study:

  • To compare the performance of traditional in-line instruments with articulating instruments in both conventional and single-port access surgery settings.
  • To evaluate the impact of instrument type on task completion time and efficiency.

Main Methods:

  • The Fundamentals of Laparoscopic Surgery (FLS) peg transfer task was utilized.
  • Tasks were performed using a standard 3-port approach and a single-port access (SPA) device.
  • Both standard rigid instrumentation and articulating instrumentation were assessed.

Main Results:

  • SPA procedures took significantly longer than conventional approaches (198 ± 74 vs 144 ± 54 seconds, P < .001).
  • Articulating instruments increased procedural time compared to rigid instruments overall (201 ± 66 vs 141 ± 58 seconds, P < .001).
  • In SPA, rigid instruments were faster than articulating instruments (173 vs 223 seconds, P = .013), while in the conventional model, rigid instruments were also faster (108 vs 179 seconds, P < .001).

Conclusions:

  • Single-port access surgery requires longer task completion times compared to conventional multi-port surgery.
  • Articulating instruments demonstrate a potential benefit in single-port access surgery, despite longer initial task times.