Use of a robotic camera holder (FreeHand®) for laparoscopic appendicectomy

Introduction: Use of a mechanical arm to hold the laparoscopic camera has many advantages. FreeHand® (FreeHand Ltd, Guildford, United Kingdom) is a robotic camera holder which uses head movement and infrared technology. This trial assessed the usefulness of FreeHand® in laparoscopic appendicectomy.Material and methods: This was a single center prospective cohort study on patients undergoing emergency laparoscopic appendicectomy using FreeHand®. Patient demographics, operative details, conversion to human camera holder and surgeon discomfort were recorded. Utilization of assistant time while not assisting was also recorded.Results: Twenty-two participants were included, with a mean age of 32 years and a mean BMI of 25.3. The mean set up time was nine minutes. There were five conversions to a manual camera holder (22.7%). There were 22 lens cleaning episodes with nine (40.9%) not requiring any lens cleaning and six (27.3%) requiring one clean. There were no peri-operative complications. Most surgeons reported minimal or no discomfort. Assistant’s time was used for ward work (57%), clerking patients (36%) and for a break (7%).Conclusions: FreeHand® can be safely used in laparoscopic appendicectomy. It provides a stable image, puts the surgeon in control of the surgical field, causes minimal user discomfort, and frees up personnel.