Is it Beneficial to Utilize an Articulating Instrument in Single-Port Laparoscopic Gastrectomy?

Kim, Amy; Lee, Chang Min

doi:10.5230/jgc.2021.21.e2

Cited by 21 publications

(15 citation statements)

References 31 publications

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“…The shaft diameter is 10 mm [11,12] The ArtiSential ® (Figure 3E) is an 8 mm diameter pistol-handle instrument. It has zero ben radius when deflected; its wrist function is guaranteed by two joints at the end effector that couples their movements with the ones of the handle [13][14][15][16][17][18].…”

Section: Intuitool ® (Unemed Corporation Omaha Ne Usa)mentioning

confidence: 99%

ArtiSential® Articulated Wrist-Like Instruments and Their First Application in Pediatric Minimally Invasive Surgery: Case Reports and Literature Review of the Most Commonly Available Robot-Inspired Devices

et al. 2021

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Background: Robotic surgery is currently a reality in surgical practice, and many endeavors have been made to extend its application also in pediatric surgery. In the absence of easy access to a robotic surgical system, new devices have been developed to offer a valid alternative such as wristed instruments. These differ from conventional laparoscopic instruments owing to a wrist-like mechanism at the tip, which faithfully reproduces the movements of the surgeon’s hands, regaining more movement’s degrees; Methods: We present two case reports in which the patients were subjected to minimally invasive procedures with aid of wristed instruments, followed by a review of the literature regarding the devices commonly marketed; Results: Articulated or wristed instruments render the same features seen in robotic surgery, such as major dexterity in smaller spaces, restitution of more natural movements and the ability to get over obstacles in a direct visual line. Our center recently equipped with ArtiSential® articulated instruments and so far, they have proven to be of great value; Conclusions: wristed instruments could represent a standpoint for surgeons wanting to benefit from the advantages of robotic surgery with a cost-sensitive perspective.

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Section: Intuitool ® (Unemed Corporation Omaha Ne Usa)mentioning

confidence: 99%

ArtiSential® Articulated Wrist-Like Instruments and Their First Application in Pediatric Minimally Invasive Surgery: Case Reports and Literature Review of the Most Commonly Available Robot-Inspired Devices

et al. 2021

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“…Technically, robotic surgery can provide 3D images, endowrist articulation, and tremor filtering, which can increase the number of retrieved lymph nodes without causing excessive bleeding compared with laparoscopic surgery [ 8 , 12 , 18 , 28 ]. Therefore, the intrinsic advantage of the robotic device makes robotic reduced-port surgery less technically demanding than the single-port or reduced-port laparoscopic surgeries, especially during lymph node dissection [ 18 , 29 , 30 ]. In other words, the difference in the degree of operative difficulty associated with tissue dissection between robotic reduced-port and conventional four-port surgeries might be less significant compared with the difference between reduced-port and conventional port laparoscopic gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

Reduced-port robotic radical gastrectomy for gastric cancer: a single-institute experience

2022

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Background Reduced-port laparoscopic gastrectomy can potentially reduce postoperative pain and improve recovery time. However, the inherent difficulty caused by the narrow manipulation angle makes this operation difficult, especially during lymph node dissection. The intrinsic advantage of the da Vinci® robotic system might offset this difficulty, maintaining adequate surgical quality with risks of surgical complications equal to those by the conventional four-port robotic approach. The aim of this study was to compare the reduced-port robotic approach and the conventional four-port approach in terms of postoperative pain and short-term surgical outcomes. Methods All patients who underwent radical gastrectomy with D2 lymph node dissection using the da Vinci Xi robotic system, including reduced-port or conventional four-port approach, were analyzed retrospectively. The primary outcome was postoperative pain assessed using the numerical rating scale (NRS). The secondary outcomes were the number of harvested lymph nodes, operation time, length of hospital stay, and postoperative 30-day complications. Results Forty-eight patients were enrolled in the study, 10 cases in the reduced-port and 38 in the conventional four-port group. Postoperative NRS revealed no significant difference between the reduced-port and conventional four-port groups [postoperative day (POD) 1: 4.5 vs. 3, p = 0.047, POD 3: 4 vs. 3, p = 0.178]. After propensity score matching, there were no significant differences in the median number of harvested lymph nodes, operation time, and length of hospital stay between the groups. The postoperative 30-day complications were more frequent in the conventional four-port group, but there was no significant difference compared with the reduced-port group after propensity score matching. Conclusions Reduced-port robotic gastrectomy with D2 lymph node dissection might be comparable to the conventional four-port robotic operation in terms of postoperative pain, surgical quality, and short-term outcomes. However, further studies are required to confirm our results and clarify the advantages of the robotic reduced-port approach.

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“…Technically, robotic surgery can provide 3D images, endowrist articulation, and tremor ltering, which can increase the number of retrieved lymph nodes without causing excessive bleeding compared with laparoscopic surgery [8,12,18,28]. Therefore, the intrinsic advantage of the robotic device makes robotic reduced-port surgery less technically demanding than the single-port or reduced-port laparoscopic surgeries, especially during lymph node dissection [18,29,30]. In other words, the difference in the degree of operative di culty associated with tissue dissection between robotic reduced-port and conventional four-port surgeries might be less signi cant compared with the difference between reduced-port and conventional port laparoscopic gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

Reduced-Port Robotic Radical Gastrectomy For Gastric Cancer: A Single-Institute Experience

Wang

Chen

Huang

2022

Preprint

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Background: Reduced-port gastrectomy can potentially reduce postoperative pain and improve recovery time. However, the inherent difficulty caused by the narrow manipulation angle makes this operation difficult, especially during lymph node dissection. The intrinsic advantage of the da Vinci robotic system might offset this difficulty, maintaining adequate surgical quality with risks of surgical complications equal to those by the conventional four-port robotic approach. The aim of this study was to compare the reduced-port robotic approach and the conventional four-port approach in terms of postoperative pain and short-term surgical outcomes. Methods: All patients who underwent radical gastrectomy with D2 lymph node dissection using the da Vinci Xi robotic system, including reduced-port or conventional four-port approach, were analyzed retrospectively. The primary outcome was postoperative pain assessed using the numerical rating scale (NRS). The secondary outcomes were the number of harvested lymph nodes, operation time, length of hospital stay, and postoperative 30-day complications. Results: Postoperative NRS revealed no significant difference between the reduced-port and conventional four-port groups (postoperative day (POD) 1: 4.5 vs 3, p = 0.047, POD 3: 4 vs 3, p = 0.178). After propensity score matching, there were no significant differences in the median number of harvested lymph nodes, operation time, and length of hospital stay between the groups. The postoperative 30-day complications were more frequent in the conventional four-port group, but there was no significant difference compared with the reduced-port group after propensity score matching. Conclusion: Reduced-port robotic gastrectomy with D2 lymph node dissection was not inferior to the conventional four-port robotic operation in terms of postoperative pain, surgical quality, and short-term outcomes. The surgeon should achieve a balance between cosmetic concerns and patient safety.

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Is it Beneficial to Utilize an Articulating Instrument in Single-Port Laparoscopic Gastrectomy?

Cited by 21 publications

References 31 publications

ArtiSential® Articulated Wrist-Like Instruments and Their First Application in Pediatric Minimally Invasive Surgery: Case Reports and Literature Review of the Most Commonly Available Robot-Inspired Devices

ArtiSential® Articulated Wrist-Like Instruments and Their First Application in Pediatric Minimally Invasive Surgery: Case Reports and Literature Review of the Most Commonly Available Robot-Inspired Devices

Reduced-port robotic radical gastrectomy for gastric cancer: a single-institute experience

Reduced-Port Robotic Radical Gastrectomy For Gastric Cancer: A Single-Institute Experience

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