A Tiny System but a Giant Help! -- MEDICA - World Forum for Medicine


TRUMPF Medizin Systeme GmbH + Co. KG

A Tiny System but a Giant Help!

ViKY® assists surgeons with laparoscopic procedures

With the compact and intelligent ViKY® assistance system, TRUMPF offers a unique concept to relieve surgeons in general surgery, urology and gynecology. The system can be used to guide the endoscope during laparoscopic procedures and as a holding and positioning system for utering manipulators.

Using the endoscope requires assistance
The endoscope has become the surgeon’s “remote eyes”. This device makes it possible to carry out operations inside the patient’s body without a direct view of the surgical site. While viewing a monitor, the surgeon has to hold the instruments exactly in place and guide them within the patient’s body. The first challenge is that the image on the screen is only two-dimensional, however, the direction along which the instruments work is seldom congruent to the viewing direction. Additionally, the instruments can be moved to only a limited extent, within a restricted field of movement. Since the surgeon must use both hands to guide the instrument, an assistant surgeon is called upon to hold and guide the endoscopic camera. That assistant must constantly try to predict where the surgeon will want to look next – and must respond quickly and correctly to the surgeon’s instructions. It is often necessary to maintain a fixed and static position for a very long time. This strenuous and monotonous task quickly leads to fatigue. It is hardly possible to keep the endoscope lens from making contact with tissue. This makes it necessary to clean the lens which necessitates time-consuming new positioning of the endoscope.

System to assist in guiding the endoscope
ViKY® solves this problem. The system takes over these tasks and the assistant surgeon can then be employed more efficiently during the operation. The assistance system is comprised of a control unit and a compact robotic unit, mounted on the operating table’s rail system by way of an articulated arm. Adapters are available to interface with all the standard endoscope optical systems and cameras and with uterine manipulators. The surgeon takes full control of the system, using voice commands or foot control pedals. Thus, the surgeon can guide, position and hold instruments during the operation without further help. The assistance system keeps the endoscope still which improves the quality of the endoscopic image. The movements are predictive and correspond to the surgeon’s normal routines and preferences. This precise positioning reduces the amount of contact between tissues and the lens and, in turn, reduces the number of interruptions needed for cleaning. This also makes it possible to carry out certain laparoscopic procedures without an assistant surgeon. That represents a great advantage in emergencies and at night shifts with limited staffing.

Easy integration
The compact design and low weight of just 1.5 kilograms make it easy to integrate ViKY® into the operating environment. Short set-up times make it possible to maintain surgical workflows. All the components used close to the surgical site can be sterilized in the autoclave, eliminating the need for sterile drapes. The system is available in three sizes to cover a broad range of uses – from conventional multi-port laparoscopy to single-port interventions. ViKY® can store different positions in memory and assume those again on command. This can be done by as many as fifty different surgeons who are using the system jointly, but can configure it personally.