Quality of laparoscopic camera navigation in robot-assisted versus conventional laparoscopic surgery for rectal cancer: An analysis of surgical videos through a video processing computer software

Abstract

Background To compare laparoscopic camera navigation (LCN) quality between robot-assisted laparoscopic surgery (RALS) and conventional laparoscopic surgery (CLS). Methods 20 recordings were selected by propensity score matching and subjected to Python (R) software to generate single frames at one second intervals. For each frame, the pixel where the camera should be centred, based on instrument position, current action (dissection/haemostasis/traction) in the frame, was detected. LCN quality was reviewed by two independent surgeons to evaluate erroneous LCN. Results RALS had higher incidence of centred views (83.1 +/- 4.02% vs. 76.0 +/- 2.38%, p < 0.05) and a shorter distance between actual and optimal frame centres (123.3 +/- 9.8 vs. 144.8 +/- 13.9, p < 0.05) compared to CLS. Erroneous camera navigations were more frequent in CLS regarding total time of horizontal alignment failure (2.1 +/- 2.2 vs. 6.0 +/- 5.4 min, p = 0.063) and number of excessive zoom-in visualization (0.1 +/- 0.3 vs. 1.9 +/- 1.4, p = 0.003). Conclusions RALS provided higher LCN quality than did CLS, emphasising the benefits of a surgeon-controlled view.