Laparoscopic intracorporal colorectal sutured anastomosis using the Radius Surgical System in a phantom model

Bermúdez, Julio Ricardo Torres; Bueß, G.; Waseda, Masahiro; Gacek, I. A.; Garcia, F. Becerra; Manukyan, G. A.; Inaki, Noriyuki

doi:10.1007/s00464-008-9992-y

Cited by 20 publications

(5 citation statements)

References 25 publications

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“…The steerable tip enlarges the instrument's workspace and allows the surgeon to reach structures that were otherwise inaccessible before [9]. Many studies have demonstrated the feasibility and advantages of steerable devices in clinical applications [2,4,[8][9][10][11][12][13][14][15][16]. Such instruments are also beneficial for single-port laparoscopic surgery, which seeks to reduce invasiveness and trauma to the patient.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Laparoscopic Steerable Instruments Performed by Expert Surgeons and Novices

Lacitignola

Trisciuzzi

Imperante

et al. 2020

Veterinary Sciences

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As an alternative to the surgical robot, some medical companies have engineered new steerable devices that mimic the robot’s capacities. This study aimed to assess how steerable instruments ameliorate the efficacy of suturing in comparison with the traditional instrument, and a combination instruments, performed by experienced and novice surgeons. The study was performed by three experienced surgeons and three novice surgeons. The instruments employed were divided into three surgical sets: two steerable dissectors; one steerable dissector and one straight needle; two straight needle holders. The study supervisor recorded the total time for the procedure, the number of bites completed, the time for each bite, and the quality of the procedure. In our study, we found consistent data demonstrating that experienced laparoscopists completed the prescribed suture pattern with more bites in less time than novices. The use of two steerable instruments was more time consuming than standard straight instruments, but a combination of instruments was significantly less time consuming, as was the use of two straight needle holders. This result was even observed in novice surgeons. Combining a steerable instrument with a traditional straight needle holder provided more advantages in this study.

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Section: Introductionmentioning

confidence: 99%

Comparison of Laparoscopic Steerable Instruments Performed by Expert Surgeons and Novices

Lacitignola

Trisciuzzi

Imperante

et al. 2020

Veterinary Sciences

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“…In 2007, Torres et al . found that 21 cases were needed to achieve a satisfactory laparoscopic anastomoses time ( 12 ). In a recent study, the learning curve of laparoscopic right hemicolectomy with overlap anastomosis was decreased gradually and stabilized after 5 cases for experienced surgeons ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

A multidimensional learning curve analysis of totally laparoscopic ileostomy reversal using a single surgeon' s experience

Zheng

Zhang

et al. 2023

Front. Surg.

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PurposeRecently, totally laparoscopic ileostomy reversal (TLAP) has received increasing attention and exhibited promising short-term outcomes. The aim of this study was to detail the learning process of the TLAP technique.MethodsBased on our initial experience with TLAP from 2018, a total of 65 TLAP cases were enrolled. Demographics and perioperative parameters were assessed using cumulative sum (CUSUM), moving average, and risk-adjusted CUSUM (RA-CUSUM) analyses.ResultsThe overall mean operative time (OT) was 94 min and the median postoperative hospitalization period was 4 days, and there was an estimated 10.77% incidence rate of perioperative complications. Three unique phases of the learning curve were derived from CUSUM analysis, and the mean OT of phase I (1–24 cases) was 108.5 min, that of phase II (25–39 cases) was 92 min, and that of phase III (40–65 cases) was 80 min, respectively. There was no significant difference in perioperative complications between these 3 phases. Similarly, moving average analysis indicated that the operation time was reduced significantly after the 20th case and reached a steady state after the 36th case. Furthermore, complication-based CUSUM and RA-CUSUM analyses indicated an acceptable range of complication rates during the whole learning period.ConclusionOur data demonstrated 3 distinct phases of the learning curve of TLAP. For an experienced surgeon, surgical competence in TLAP can be grasped at around 25 cases with satisfactory short-term outcomes.

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“…Frede et al state that ‘compared to our experimental experiences with conventional reconstructive laparoscopic surgery the learning curve of the [Radius] is significantly shorter’, and that even complex tasks such as complete urethro-vesical anastomoses ‘require less than 10 trials to maintain a good quality of performance’ [29]. However, when performing colorectal anastomosis in a phantom model, Torres Bermudez et al found a learning curve of 21 procedures before no reduction in completion time was observed [36]. Waseda et al acknowledge that manipulation using the Radius is significantly different from traditional manual laparoscopic instruments and that tip rotation is less intuitive than robotic systems, and therefore, suggest long practice times with the instrument [37].…”

Section: Devicesmentioning

confidence: 99%

“…The studies also noted improved ergonomics in comparison to conventional laparoscopic instruments. It has also been noted that the Radius avoids forced wrist flexion and exaggerated shoulder and elbow angles that occur with conventional instruments [36]. …”

Section: Devicesmentioning

confidence: 99%

Robot-like dexterity without computers and motors: a review of hand-held laparoscopic instruments with wrist-like tip articulation

Anderson

Lathrop

Webster

2016

Expert Review of Medical Devices

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Introduction Conventional manual laparoscopic instruments for minimally invasive surgery have limited dexterity within the patient, making procedures challenging. Surgical robotic systems offer enhanced articulation, but at substantial financial costs. This has motivated the development of high-dexterity, low-cost laparoscopic instruments. Areas covered This article reviews both commercial and academic results on creating fully mechanical (i.e. non-robotic) laparoscopic instruments that provide wrists or wrist-like dexterity within the patient. We review the state of the art in the development of these mechanical instruments, focusing on the surgeon interface, wrist mechanism, and the kinematic mapping between the two. Expert commentary Current articulated mechanical laparoscopic instruments exhibit a wide range of designs, with no clear consensus on what makes such devices easy to use. As these technologies mature, user studies are needed to determine surgeon preferences. Articulated, low-cost instruments have the potential to impact the minimally invasive surgery market if they provide compelling benefits to surgeons.

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Laparoscopic intracorporal colorectal sutured anastomosis using the Radius Surgical System in a phantom model

Abstract: This study demonstrated the feasibility of laparoscopic colorectal anastomosis using RSS. Anastomosis with RSS was shown to be safer. The three participants evaluating ergonomy reflected less discomfort in hand/wrist using RSS. Others ergonomic problems were comparable to CLI.

Cited by 20 publications

References 25 publications

Comparison of Laparoscopic Steerable Instruments Performed by Expert Surgeons and Novices

Comparison of Laparoscopic Steerable Instruments Performed by Expert Surgeons and Novices

A multidimensional learning curve analysis of totally laparoscopic ileostomy reversal using a single surgeon' s experience

Robot-like dexterity without computers and motors: a review of hand-held laparoscopic instruments with wrist-like tip articulation

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