Laparoscopic low anterior resection performed using ArtiSential<sup>®</sup> in an obese male patient with a narrow pelvis — a video vignette

Darwich, Ibrahim; Scheidt, Michael; Koliesnikov, Yevhen; Willeke, Frank

doi:10.1111/codi.15473

Cited by 7 publications

(7 citation statements)

References 6 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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“…11 Similarly, rectal surgery using these forceps has been increasingly reported. [12][13][14] Their applications have also been observed in pediatric, cardiovascular, and thoracic surgeries. [15][16][17][18] In accordance with earlier studies, we found that articulated instruments could be managed almost identically to surgical robots during TMEs, leading to negligible differences between the two approaches.…”

Section: Discussionmentioning

confidence: 99%

Articulating forceps in laparoscopic total mesorectal excision: A video comparison with robotic surgery

Masui,

Itatani,

Hoshino

et al. 2024

Asian J Endoscop Surgery

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IntroductionTotal mesorectal excision (TME) is an established standard procedure for rectal surgery; however, it is technically challenging because of the deep and narrow pelvis. Minimally invasive surgeries have gained prominence for TME with favorable outcomes but come with limitations. Laparoscopic surgery often has dexterity restrictions because of the use of straight forceps, whereas robotic surgery is impeded by high costs and extended operative times. Articulating forceps aim to bridge the gap between these methods by offering enhanced dexterity at a lower cost.Patients and Surgical TechniqueThis video study involves two female patients diagnosed with lower rectal cancer. One patient underwent laparoscopic intersphincteric resection (Lap‐ISR) using the ArtiSential articulating forceps (LIVSMED Inc.), and the other underwent robot‐assisted low anterior resection (Rob‐LAR) using the da Vinci Xi System. Both operations involved similar mesorectal dissection steps, except for the anastomosis. The standard port placement was used, and dissection was performed circumferentially down to the perianal region.DiscussionThe ArtiSential demonstrated effectiveness comparable with the da Vinci Xi system in TME surgery, with the potential advantage of improved cost‐effectiveness.

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“…Case reports and video vignettes that reported feasibility and safety of the use of ARTISENTIAL ® in colorectal surgery have already been published [18,22,23].…”

Section: Discussionmentioning

confidence: 99%

“…R0 resection was confirmed in all patients with no cases of circumferential resection margin involvement. The median number of harvested lymph nodes was 15 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). The median length of the distal resection margin was 5 cm (range 1-11 cm).…”

Section: Pathologic Outcomementioning

confidence: 99%

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Early experience with the ARTISENTIAL® articulated instruments in laparoscopic low anterior resection with TME

et al. 2022

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Background The notion of articulation in surgery has been largely synonymous with robotics. The ARTISENTIAL® instruments aim at bringing advanced articulation to laparoscopy to overcome challenges in narrow anatomical spaces. In this paper, we present first single-center results of a series of low anterior resections, performed with ARTISENTIAL®. Methods Between September 2020 and August 2021, at the Department of Surgery, St. Marienkrankenhaus Siegen, Siegen, Germany, patients with cancer of the mid- and low rectum were prospectively enrolled in a pilot feasibility study to evaluate the ARTISENTIAL® articulated instruments in performing a laparoscopic low anterior resection. Perioperative and short-term postoperative data were analyzed. Results Seventeen patients (10 males/7 females) were enrolled in this study. The patients had a median age of 66 years (range 47–80 years) and a median body mass index of 28 kg/m2 (range 23–33 kg/m2). The median time to rectal transection was 155 min (range 118–280 min) and the median total operative time was 276 min (range 192–458 min). The median estimated blood loss was 30 ml (range 5–70 ml) and there were no conversions to laparotomy. The median number of harvested lymph nodes was 15 (range 12–28). Total mesorectal excision (TME) quality was ‘good’ in all patients with no cases of circumferential resection margin involvement (R0 = 100%). The median length of stay was 9 days (range 7–14 days). There were no anastomotic leaks and the overall complication rate was 17.6%. There was one unrelated readmission with no mortality. Conclusions Low anterior resection with ARTISENTIAL® is feasible and safe. All patients had a successful TME procedure with a good oncological outcome. We will now seek to evaluate the benefits of ARTISENTIAL® in comparison with standard laparoscopic instruments through a larger study.

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Laparoscopic low anterior resection performed using ArtiSential^® in an obese male patient with a narrow pelvis — a video vignette

Cited by 7 publications

References 6 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

Articulating forceps in laparoscopic total mesorectal excision: A video comparison with robotic surgery

Early experience with the ARTISENTIAL® articulated instruments in laparoscopic low anterior resection with TME

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Laparoscopic low anterior resection performed using ArtiSential® in an obese male patient with a narrow pelvis — a video vignette

Cited by 7 publications

References 6 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

Articulating forceps in laparoscopic total mesorectal excision: A video comparison with robotic surgery

Early experience with the ARTISENTIAL® articulated instruments in laparoscopic low anterior resection with TME

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Laparoscopic low anterior resection performed using ArtiSential^® in an obese male patient with a narrow pelvis — a video vignette