Feasibility of on-demand robotics in colorectal surgery: first cases.

Details

Serval ID
serval:BIB_532503B3CF68
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Feasibility of on-demand robotics in colorectal surgery: first cases.
Journal
Surgical endoscopy
Author(s)
Hahnloser D., Rrupa D., Grass F.
ISSN
1432-2218 (Electronic)
ISSN-L
0930-2794
Publication state
Published
Issued date
11/2023
Peer-reviewed
Oui
Volume
37
Number
11
Pages
8594-8600
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The key benefits of robotics are improved precision and control, thanks to fully articulated robotic instruments and enhanced, stable endoscope control. However, colorectal procedures also require large movements such as medialization of the colon where a robotic platform is not always needed. We present the world's first experience in colorectal surgery with a new open platform of on-demand robotics.
Standard laparoscopic 3-D camera, insufflator, trocars and energy devices, available in all hospitals performing laparoscopic surgery, are used in combination with the Dexter System™ from Distalmotion SA, which includes two robotic instrument arms, one robotic endoscope arm and a sterile surgeon console. We present the first 12 colorectal cases of robotic assisted ventral mesh rectopexy (n = 2), oncologic right colectomies (n = 8), transverse colectomy (n = 1) and ileocecal resection (n = 1) using the Dexter System.
The two ventral mesh rectopexies were fully robotic, requiring no switching from standard laparoscopy to robotic assistance. The robotic platform was used for central vascular ligation (CVL) in all 8 oncologic colectomies, whereas medialization of the colon and transection was performed with standard laparoscopy. The switch from laparoscopy to robotics and back was performed in 15-30 s. Intracorporal anastomosis was performed in 4 patients (stapling by standard laparoscopy and suturing of the defect with robotic assistance). Conversion or permanent switch to standard laparoscopy was required in two patients due to visceral obesity. No robotic platform-related intraoperative adverse event occurred. No major morbidity occurred at 60 days.
On-demand robotics is feasible and combines the best of two worlds: Robotics where precision and enhanced dexterity are required and standard laparoscopy where it is at its best. The surgeon remains scrubbed-in at all times, allowing a switch between robotics and laparoscopy within seconds.
Keywords
Humans, Colorectal Surgery, Feasibility Studies, Robotics/methods, Colectomy/methods, Laparoscopy/methods, Colorectal Neoplasms/surgery, Robotic Surgical Procedures, Colorectal, Dexter, Laparoscopy, Robotic surgery, Robotics
Pubmed
Web of science
Open Access
Yes
Create date
31/07/2023 12:01
Last modification date
13/12/2023 7:12
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