Comparison of Conventional Methods for Bowel Length Measurement in Laparoscopic Surgery to a Novel Computer-Assisted 3D Measurement System

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Martin Wagner - , University Hospital Heidelberg (Author)
  • Benjamin F.B. Mayer - , Heidelberg University  (Author)
  • Sebastian Bodenstedt - , National Center for Tumor Diseases (NCT) Dresden (Author)
  • Karl Friedrich Kowalewski - , Heidelberg University  (Author)
  • Felix Nickel - , Heidelberg University  (Author)
  • Stefanie Speidel - , National Center for Tumor Diseases (Partners: UKD, MFD, HZDR, DKFZ) (Author)
  • Lars Fischer - , Hospital Mittelbaden (Author)
  • Hannes G. Kenngott - , Heidelberg University  (Author)
  • Beat Peter Müller-Stich - , Heidelberg University  (Author)

Abstract

Purpose: Accurate laparoscopic bowel length measurement (LBLM), which is used primarily in metabolic surgery, remains a challenge. This study aims to three conventional methods for LBLM, namely using visual judgment (VJ), instrument markings (IM), or premeasured tape (PT) to a novel computer-assisted 3D measurement system (BMS). Materials and Methods: LBLM methods were compared using a 3D laparoscope on bowel phantoms regarding accuracy (relative error in percent, %), time in seconds (s), and number of bowel grasps. Seventy centimeters were measured seven times. As a control, the first, third, fifth, and seventh measurements were performed with VJ. The interventions IM, PT, and BMS were performed following a randomized order as the second, fourth, and sixth measurements. Results: In total, 63 people participated. BMS showed better accuracy (2.1±3.7%) compared to VJ (8.7±13.7%, p=0.001), PT (4.3±6.8%, p=0.002), and IM (11±15.3%, p<0.001). Participants performed LBLM in a similar amount of time with BMS (175.7±59.7s) and PT (166.5±63.6s, p=0.35), but VJ (64.0±24.0s, p<0.001) and IM (144.9±55.4s, p=0.002) were faster. Number of bowel grasps as a measure for the risk of bowel lesions was similar for BMS (15.8±3.0) and PT (15.9±4.6, p=0.861), whereas VJ required less (14.1±3.4, p=0.004) and IM required more than BMS (22.2±6.9, p<0.001). Conclusions: PT had higher accuracy than VJ and IM, and lower number of bowel grasps than IM. BMS shows great potential for more reliable LBLM. Until BMS is available in clinical routine, PT should be preferred for LBLM. Graphical abstract: [Figure not available: see fulltext.]

Details

Original languageEnglish
Pages (from-to)4692-4700
Number of pages9
JournalObesity Surgery
Volume31
Issue number11
Publication statusPublished - Nov 2021
Peer-reviewedYes

External IDs

PubMed 34331186
ORCID /0000-0002-4590-1908/work/163294124

Keywords

Sustainable Development Goals

Keywords

  • Bowel length measurement, Computer-assisted surgery, Metabolic surgery, Quantitative laparoscopy, Stereo endoscopy