The "iceberg Phenomenon"

As soon as one technological problem in NOTES is solved, the Next one appears!

verfasst von
Hubertus Feussner, Adam Fiolka, Armin Schneider, Timo Cuntz, Johannes Coy, Cyrill Von Tiesenhausen, Kurt Höller, Oliver Weede, Rainer Konietschke, Jan Hinnerk Borchard, Mark Ellrichmann, Silvano Reiser, Tobias Ortmaier
Abstract

Purpose. Though already proclaimed about 7 years ago, natural orifice transluminal endoscopic surgery (NOTES) is still in its early stages. A multidisciplinary working team tried to analyze the technical obstacles and identify potential solutions. Methods. After a comprehensive review of the literature, a group of 3 surgeons, 1 gastroenterologist, 10 engineers, and 1 representative of biomedical industry defined the most important deficiencies within the system and then compiled as well as evaluated innovative technologies that could be used to help overcome these problems. These technologies were classified with regard to the time needed for their implementation and associated hindrances, where priority is based on the level of impact and significance that it would make. Results. Both visualization and actuation require significant improvement. Advanced illumination, mist elimination, image stabilization, view extension, 3-dimensional stereoscopy, and augmented reality are feasible options and could optimize visual information. Advanced mechatronic platforms with miniaturized, powerful actuators, and intuitive human-machine interfaces could optimize dexterity, as long as enabling technologies are used. The latter include depth maps in real time, precise navigation, fast pattern recognition, partial autonomy, and cognition systems. Conclusion. The majority of functional deficiencies that still exist in NOTES platforms could be overcome by a broad range of already existing or emerging enabling technologies. To combine them in an optimal manner, a permanent dialogue between researchers and clinicians is mandatory.

Organisationseinheit(en)
Institut für Mechatronische Systeme
Externe Organisation(en)
Technische Universität München (TUM)
Fraunhofer-Institut für Produktionstechnik und Automatisierung (IPA)
KUKA AG
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU Erlangen-Nürnberg)
Karlsruher Institut für Technologie (KIT)
Deutsches Zentrum für Luft- und Raumfahrt e.V. (DLR)
Christian-Albrechts-Universität zu Kiel (CAU)
Typ
Artikel
Journal
Surgical innovation
Band
22
Seiten
643-650
Anzahl der Seiten
8
ISSN
1553-3506
Publikationsdatum
01.12.2015
Publikationsstatus
Veröffentlicht
Peer-reviewed
Ja
ASJC Scopus Sachgebiete
Chirurgie
Elektronische Version(en)
https://doi.org/10.1177/1553350615573578 (Zugang: Geschlossen)