Feasibility and necessity of the fourth arm of the da Vinci Si surgical system for robot‐assisted partial nephrectomy

Kira, Satoru; Mitsui, Takahiko; Sawada, Norifumi; Nakagomi, Hiroshi; Ihara, Takeshi; Takahashi, Nobuhiro; Takeda, Masayuki

doi:10.1002/rcs.2092

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…And the robotic system had a fourth arm that maintained the ideal suture angle during the operation, and the operator had the advantage of performing suturing with only simple wrist movements [ 10 17 18 ]. The effective use of the fourth arm enabled the surgeon to locate the ideal surgical position without surgical site assistants’ support [ 19 20 ]. In the ArtiSential group, the operator needed to use more force when using the needle holder because of the head weight of the device, which could limit the allowed joint range [ 21 22 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic renal surgery using multi degree-of-freedom articulating laparoscopic instruments in a porcine model

et al. 2023

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Purpose We evaluated the performance of a new multi-degree-of-freedom articulating laparoscopic instrument, ArtiSential, and compared it with that of a straight-shaped instrument and the da Vinci surgical system, in renal surgery using porcine model. Materials and Methods Nine female Yorkshire pigs were equally divided into three groups. The three groups were compared at each surgical step in terms of objective and subjective parameters. Results The median operative times for renal pedicle clamping and ureter dissection were significantly shorter in ArtiSential group than robotic group (1.3 min vs. 4.7 min, p=0.002; 8.1 min vs. 11.1 min, p=0.015). The median operative time for bladder repair was significantly longer in ArtiSential group than robotic and straight-shaped groups (17.9 min vs. 5.5 min, p=0.002; 17.9 min vs. 9.3 min, p=0.026). There were no significant differences among groups in terms of blood loss or intraoperative complications. ArtiSential device was less useable for renorrhaphy (p=0.009) and bladder repair (p=0.002) compared to the robotic system. ArtiSential group was less accurate than robotic group in terms of tumor resection, renorrhaphy, and bladder repair. During ureter dissection, bladder cuff excision, and bladder repair, the surgeon experienced greater wrist discomfort but lesser back discomfort in ArtiSential group than robotic group. Conclusions For most steps, ArtiSential performed as well as robotic and straight-shaped instruments. The development of specialized surgical techniques for ArtiSential will maximize the advantages of these instruments.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic renal surgery using multi degree-of-freedom articulating laparoscopic instruments in a porcine model

et al. 2023

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“…RAPN was performed by five surgeons (SK, TM, NS, HN, and TI), as previously described [10]. We used the AirSeal TM Insufflation System (CONMED Japan KK, Tokyo, Japan).…”

Section: Surgery and Chest Radiographymentioning

confidence: 99%

Risk Factors for Atelectasis or Pneumomediastinum After Robot-Assisted Partial Nephrectomy

Yano¹,

Kira²,

Takahashi³

et al. 2021

Cureus

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Several complications of robot-assisted partial nephrectomy (RAPN) have been reported; however, there are limited data on thoracic findings and complications. We investigated the risk factors for atelectasis or pneumomediastinum after robot-assisted partial nephrectomy. MethodsThis retrospective cohort study included 84 consecutive patients who underwent robot-assisted partial nephrectomy with the da Vinci Si System and the AirSeal TM Insufflation System. Based on chest radiography findings obtained postoperatively in the operating room, patients with and without atelectasis or pneumomediastinum were categorized into Groups A and B, respectively. Patient characteristics (age, sex, body mass index (BMI), RENAL nephrometry score, tumor size, and surgical approach) and perioperative outcomes (total operative time, console time, warm ischemic time, and estimated blood loss) were compared using the Mann-Whitney U test and chi-square test. A multivariate logistic regression analysis was performed to identify the risk factors associated with atelectasis or pneumomediastinum. ResultsGroups A and B included 31 and 53 patients, respectively. Although the rate of the retroperitoneal approach was significantly higher in Group A than in Group B, the other parameters and perioperative outcomes did not differ. The multivariate logistic regression analysis showed that the retroperitoneal approach and high body mass index were risk factors for atelectasis or pneumomediastinum after robot-assisted partial nephrectomy. However, these abnormal findings disappeared spontaneously without requiring postoperative treatment. ConclusionsThe retroperitoneal approach and high body mass index may be risk factors for atelectasis or pneumomediastinum after robot-assisted partial nephrectomy.

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Feasibility and necessity of the fourth arm of the da Vinci Si surgical system for robot‐assisted partial nephrectomy

Cited by 2 publications

References 19 publications

Laparoscopic renal surgery using multi degree-of-freedom articulating laparoscopic instruments in a porcine model

Laparoscopic renal surgery using multi degree-of-freedom articulating laparoscopic instruments in a porcine model

Risk Factors for Atelectasis or Pneumomediastinum After Robot-Assisted Partial Nephrectomy

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