Background: Advances in computer enhancements for surgery, including a voice-activated control
system for minimally invasive surgery, are being introduced into clinical practice. Few reports have
objectively evaluated the utility of the voice-activated control system. The aim of this study was to
evaluate the utility of a voice-activated control system for delivery of commands to specific operating
room (OR) equipment.
Materials and Methods: We evaluated a total of 30 laparoscopic procedures: 15 laparoscopic hernia
repairs, 10 laparoscopic cholecystectomies, and 5 laparoscopic fundoplications performed with
the HERMES™ Operating Room Control Center (Computer Motion, Santa Barbara, California)
voice-activated control system. When the voice command (VC) to the HERMES system was given,
the circulating nurse was observed and her location was recorded. The 3 locations were A, the nurse
was immediately available in the OR, not engaged in any other tasks; B, the nurse was in the OR
but engaged in other tasks; or C, the nurse was outside the OR.
Results: The 30 cases were performed by the same surgeon and completed laparoscopically. For
170 VCs for gas insufflation, the location of the circulating nurse was: A = 50, B = 98, and C = 22.
For 135 light source adjustments, the locations were A = 34, B = 82, and C = 19. In 76 white balance
VCs: A = 16, B = 51, and C = 9. In 128 VCs for camera adjustment: A = 27, B = 77, and C =
24. Eight video capture VCs: A = 1, B = 3, and C = 4. For 69 image capture VCs: A = 5, B = 41,
and C = 23. The total number of VCs was 586: A = 133 (22.7%), B = 352 (60%), and C =
101(17.3%). All VCs were accurately interpreted by the HERMES system.
Conclusion: Voice-activated control systems improve communication with and efficiency of OR
staff. The surgeon is afforded the most timely equipment adjustment possible. Circulating nurses
are allowed to concentrate on patient care instead of equipment adjustment during the course of
the surgery.
