During minimally invasive procedures an assistant is controlling the laparoscope. Ideally, the surgeon should be able to manipulate all instruments including the camera him/herself, to avoid communication problems and disturbing camera movements. Camera holders return camera-control to the surgeon and stabilize the laparoscopic image. An additional holder can be used to stabilize an extra laparoscopic instrument for retracting. A literature survey has been carried out giving an overview of the existing “robotic” and passive camera and instrument holders and, if available, results of their clinical value. Benefits and limitations were identified. Most studies showed that camera holders, passive and active, provide the surgeon with a more stable image and enables them to control their own view direction. Only the passive holders were suitable for holding instruments. Comparisons between different systems are reviewed. Both active and passive camera and instrument holders are functional, and may be helpful to perform solo-surgery. The benefits of active holders are questionable in relation to the performance of the much simpler passive designs.
From the *Medical Technological Development Department, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands and †Man-Machine Systems Group, Faculty of Design, Engineering and Production, Delft University of Technology, Mekelweg 2, The Netherlands
Received for publication April 30, 2003;
accepted February 8, 2004.
Reprints: J.E.N. Jaspers, Medical Technological Development Department, Academic Medical Center K01-58, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands (e-mail: firstname.lastname@example.org).