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22.01.2019 | 2018 EAES Oral | Ausgabe 10/2019

Surgical Endoscopy 10/2019

Innovation in surgery/operating room driven by Internet of Things on medical devices

Surgical Endoscopy > Ausgabe 10/2019
Yuki Ushimaru, Tsuyoshi Takahashi, Yoshihito Souma, Yoshitomo Yanagimoto, Hirotsugu Nagase, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Masaki Mori, Yuichiro Doki, Kiyokazu Nakajima
Wichtige Hinweise
This work was presented during the Gerhard Buess Technology Award session of the 26th International EAES Congress, London, UK, 30 May–1 June 2018.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.



With the improvement of sensor technology, the trend of Internet of Things (IoT) is affecting the medical devices. The aim of this study is to verify whether it is possible to “visualize instrument usage in specific procedures” by automatically accumulating the digital data related to the behavior of surgical instruments/forceps in laparoscopic surgery.


Five board-certified surgeons (PGY 9–24 years) performed laparoscopic cholecystectomy on 35-kg porcine (n = 5). Radio frequency identifier (RFID) was attached to each forceps with RFID readers installed on the left/right of the operating table. We automatically recorded the behavior by tracking the operator’s right/left hands’ forceps with RFID. The output sensor was installed in the electrocautery circuit for automatic recordings of the ON/OFF times and the activation time. All data were collected in dedicated software and used for analysis.


In all cases, the behaviors of forceps and electrocautery were successfully recorded. The median operation time was 1828 s (range 1159–2962 s), of which the electrocautery probe was the longest held on the right hand (1179 s, 75%), followed by Maryland dissectors (149 s, 10%), then clip appliers (91 s, 2%). In contrast, grasping forceps were mainly used in the left hand (1780 s, 93%). The activation time of electrocautery was only 8% of the total use and the remaining was mainly used for dissection. These situations were seen in common by all operators, but as a mentor surgeon, there was a tendency to change the right hand’s instruments more frequently. The median activation time of electrocautery was 0.41 s, and these were confirmed to be 0.14–0.57 s among the operators.


By utilization of IoT for surgery, surgical procedure could be “visualized.” This will improve the safety on surgery such as optimal usage of surgical devices, proper use of electrocautery, and standardization of the surgical procedures.

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