Use of a robotic camera holder (FreeHand^®) for laparoscopic appendicectomy

Introduction: Use of a mechanical arm to hold the laparoscopic camera has many advantages. FreeHand (FreeHand Ltd, Guildford, United Kingdom) is a robotic camera holder which uses head movement and infrared technology. This trial assessed the usefulness of FreeHand in laparoscopic appendicectomy.Material and methods: This was a single center prospective cohort study on patients undergoing emergency laparoscopic appendicectomy using FreeHand. Patient demographics, operative details, conversion to human camera holder and surgeon discomfort were recorded. Utilization of assistant time while not assisting was also recorded.Results: Twenty-two participants were included, with a mean age of 32 years and a mean BMI of 25.3. The mean set up time was nine minutes. There were five conversions to a manual camera holder (22.7%). There were 22 lens cleaning episodes with nine (40.9%) not requiring any lens cleaning and six (27.3%) requiring one clean. There were no peri-operative complications. Most surgeons reported minimal or no discomfort. Assistant's time was used for ward work (57%), clerking patients (36%) and for a break (7%).Conclusions: FreeHand can be safely used in laparoscopic appendicectomy. It provides a stable image, puts the surgeon in control of the surgical field, causes minimal user discomfort, and frees up personnel.