Operating Room Awareness with the Smart Trocar: Innovative Laparoscopic Surgery

Laparoscopic surgery is a popular alternative to open surgery due to the considerable reduction of recovery time, pain, scaring, and complications. During laparoscopic surgery, operations are performed through small incisions (usually around 1cm) elsewhere in the body. However, limited access to the operating field, indirect 2D vision of a 3D complex scene, the presence of mirror effect, and operating rooms originally built for open surgery, conspire to make the surgeon's work more difficult and less efficient. We present a new technology, the Smart Trocar, which can compensate for these drawbacks by providing a global positioning system of the laparoscopic tools that are inserted into the body. Our system uses a single wireless camera, which stays outside the body and tracks some features inside the operating room. With this simple and inexpensive device, we can, at any time, and within few millimeters accuracy, both recognize and localize the rigid surgical instruments. Applications of this invention are multiple. For examples, it can be used as a pointer to localize specific part of the organs during a laparoscopic surgery. It can also be used to analyze tools paths and to evaluate surgical dexterity of residents in order to improve their training. We present in this report an analysis of the tool trajectories that allows us to determine the level of skill of a resident based on his results to few laparoscopic exercises. Our study proves the correlation between surgical dexterity and economy of motion.