On-demand robotics-The best of both worlds for robotic-assisted laparoscopic surgery.

Details

Serval ID
serval:BIB_8952345BB432
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
On-demand robotics-The best of both worlds for robotic-assisted laparoscopic surgery.
Journal
Surgery
Author(s)
Grass F., Hahnloser D.
ISSN
1532-7361 (Electronic)
ISSN-L
0039-6060
Publication state
Published
Issued date
11/2024
Peer-reviewed
Oui
Volume
176
Number
5
Pages
1534-1537
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
A modular, combined use of robotic and laparoscopic platforms has been suggested to address challenges in optimal workspace utilization. The 3-arm on-demand open Dexter Robotic System was developed to combine the advantages of robot-assisted precision surgery in narrow spaces with the laparoscopic approach for frequent position changes in larger spaces. The system integrates 2 patient carts, a fully controllable endoscope arm, and a sterile surgeon open console, allowing for a rapid switch between robot-assisted surgery and laparoscopy. When switching, the robotic arms may be folded into a laparoscopic home position at any time during a procedure, allowing unrestricted access to the patient. Switches take 15-30 seconds, occurring seamlessly without redocking or recalibrating upon returning to the robotic mode. During oncologic colorectal resections, some procedure steps (eg, central vessel ligation and lymphadenectomy) are best suited for the robotic approach, providing advantages related to 3-dimensional vision, improved ergonomics, and improved dexterity within confined spaces. In contrast, the laparoscopic platform is better suited for procedure steps requiring frequent movements within a large workspace (eg, lateral to medial mobilization of the colon). The Dexter system provides a portfolio of 7 robotic instruments with monopolar and bipolar function operating with any existing available generator. Furthermore, existing operating room equipment, including insufflating devices, optics, and trocars can be used with the Dexter robotic platform. Recently, the first published clinical experience from the authors' institution, involving 12 pilot cases, demonstrated the safety and feasibility for right colonic resections for benign and malignant indications and ventral mesh rectopexies.
Keywords
Humans, Laparoscopy/methods, Laparoscopy/instrumentation, Robotic Surgical Procedures/methods, Robotic Surgical Procedures/instrumentation, Equipment Design
Pubmed
Web of science
Create date
09/09/2024 14:13
Last modification date
26/10/2024 6:12
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