This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Fabio Biscegli Jatene Marcos Naoyuki Samano Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Martins Rua, J. F. Articles by Das-Neves-Pereira, J. C. Search for Related Content PubMed PubMed Citation Articles by Martins Rua, J. F. Articles by Das-Neves-Pereira, J. C.

Robotic versus human camera holding in video-assisted thoracic sympathectomy: a single blind randomized trial of efficacy and safety

Department of Thoracic Surgery, University of São Paulo, Medical School, Heart Institute (InCor), Clinics Hospital, São Paulo, SP, Brazil

*Corresponding author. 342 Teodoro Sampaio Street, apt 62, 05406-000, São Paulo, SP, Brazil. Tel.: +55-11-81747696; fax: +55-11-30697145.

E-mail address: joaocnp{at}hotmail.com (J.C. Das-Neves-Pereira).

Our objective is to compare surgical safety and efficacy between robotic and human camera control in video-assisted thoracic sympathectomy. A randomized-controlled-trial was performed. Surgical operation was VATS sympathectomy for hyperhidrosis. The trial compared a voice-controlled robot for holding the endoscopic camera robotic group (Ro) to human assisted group (Hu). Each group included 19 patients. Sympathectomy was achieved by electrodessication of the third ganglion. Operations were filmed and images stored. Two observers quantified the number of involuntary and inappropriate movements and how many times the camera was cleaned. Safety criteria were surgical accidents, pain and aesthetical results; efficacy criteria were: surgical and camera use duration, anhydrosis, length of hospitalization, compensatory hyperhidrosis and patient satisfaction. There was no difference between groups regarding surgical accidents, number of involuntary movements, pain, aesthetical results, general satisfaction, number of lens cleaning, anhydrosis, length of hospitalization, and compensatory hyperhidrosis. The number of contacts of the laparoscopic lens with mediastinal structures was lower in the Ro group (P<0.001), but the total and surgical length was longer in this group (P<0.001). Camera holding by a robotic arm in VATS sympathectomy for hyperhidrosis is as safe but less efficient when compared to a human camera-holding assistant.

Key Words: Robotics; Thoracoscopy/VATS; Sympathectomy; Hyperhidrosis; Randomized controlled trials