Medrobotics <scp>F</scp>lex transanal excision of a rectal gastrointestinal stromal tumour: first video of the transanal <scp>F</scp>lex robot used in a human – a video vignette

Paull, Jessie Osborne; Pudalov, Natalie; Obias, Vincent

doi:10.1111/codi.14378

Cited by 16 publications

(8 citation statements)

References 3 publications

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“…There are reports of these devices accessing the hypopharynx and the rectum with good dexterity. 16,17 Nevertheless, there are very limited data to date on whether these devices can provide a stable platform to access distant organs from the natural orifices.…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Transrectal Cholecystectomy in a Porcine Model

et al. 2019

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Background. With increasing experience and technological advancement in surgical instruments, surgeons have explored the feasibility of single-incision laparoscopic surgery and natural orifice transluminal endoscopic surgery (NOTES). These techniques aim to further reduce surgical trauma, but are not popular due to their inherent pitfalls including clashing of instruments, lack of counter traction, lengthy operating time, and so on. A novel surgical robotic system was designed to overcome the limitations of the existing technologies. Animal trials were conducted to demonstrate its feasibility in performing robotic-assisted transrectal cholecystectomy in a porcine model. Method. The Novel surgical robotic system is a high dexterity, single access port surgical robotic system that enables surgeons to carry out single-port surgical procedure or NOTES. The proposed system’s main features include the ability to perform intraabdominal and pelvic surgeries via natural orifices like the vagina or rectum. The system is equipped with multiple miniaturized (16 mm diameter) internally motorized robotic arms, each with a minimum of 7 degrees of freedom, a dual in vivo camera system, a cannula, and an external swivel system. Results. Robotic-assisted transrectal cholecystectomy was successfully performed in 3 adult male pigs. The estimated blood loss was <10 mL in all 3 cases. There were no intraoperative complications. The system provided good dexterity and clear vision. Conclusions. The trial demonstrated that the system can provide the surgeon a stable platform with adequate spacing for the transrectal insertion of robotic arms, 3-dimensional vision, and enhanced dexterity in performing NOTES cholecystectomy.

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Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Transrectal Cholecystectomy in a Porcine Model

et al. 2019

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“…Recently, the device has been modified to maintain insufflation, allowing transanal access to the sigmoid colon and the deployment of compatible articulating instruments to facilitate tissue dissection. This system was cleared by the U.S. Food and Drug Administration in 2017 12, 13…”

Section: Tools and Techniquementioning

confidence: 99%

Robotic-assisted surgical endoscopy: a new era for endoluminal therapies

Aihara

Thompson

2019

VideoGIE

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Minimally invasive endoscopic procedures are associated with lower adverse events and shorter hospital stays compared with conventional open surgery. 1,2 However, some advanced endoscopic procedures, including endoscopic submucosal dissection (ESD), natural orifice transluminal endoscopic surgery (NOTES), and suturing, have typically required specialized training and a certain amount of experience to achieve competency. Therefore, these procedures are not widely performed in nonspecialized centers. 3-6 Despite the availability of a wide range of accessory devices, including distal attachment caps, electrosurgical knifes, hemostatic forceps, and suturing devices, the conventional flexible endoscopes used in clinical practice struggle to support the performance of advanced endosurgical procedures. They lack the dexterity required to perform useful maneuvers, such as triangulation of instruments and nonaxial tissue manipulation. Transmission of

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“…We believe that, at any rate, the significance of the transanal approach will endure, particularly in cases with difficulty via the transabdominal approach, whether open, laparoscopic, or robotic 54) . Recently, transanal use of robotic platforms has been reported to reduce the limitations of the ergonomics of single-port surgery [61][62][63][64] . Furthermore, with the advent of robotic platforms designed for single-port surgery, robotic transanal surgery has been expected to overcome the limitations of single-port surgery 61,62,64) .…”

Section: Future Prospectsmentioning

confidence: 99%

“…Recently, transanal use of robotic platforms has been reported to reduce the limitations of the ergonomics of single-port surgery [61][62][63][64] . Furthermore, with the advent of robotic platforms designed for single-port surgery, robotic transanal surgery has been expected to overcome the limitations of single-port surgery 61,62,64) . While these approaches might not be mutually exclusive, a combination of the modalities might lead to better outcomes, including NOTES.…”

Section: Future Prospectsmentioning

confidence: 99%

Transanal TME: new standard or fad?

Hasegawa

Yoshida

Morimoto

et al. 2019

J Anus Rectum Colon

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Transanal total mesorectal excision (taTME) has been developed to overcome the difficulty of laparoscopic dissection and transection in the deep pelvis. TaTME has several clinical benefits over laparoscopic surgery, such as better exposure of the distal rectum and direct determination of distal resection margin. Although evidence demonstrating the true benefits of taTME over laparoscopic TME (LapTME) is still insufficient, accumulating data have revealed that, as compared with LapTME, taTME is associated with shorter operative time and a lower conversion rate without jeopardizing other short-term outcomes. However, taTME is a technically demanding procedure with specific complications such as urethral injury, and so sufficient experience of LapTME and step-by-step acquisition of the skills needed for this procedure are requisite. The role of transanal endoscopic surgery is expected to change, along with the recent progress in the treatment of rectal cancer, such as robotic surgery and the watch-and-wait strategy. Optimization of treatment will be needed in the future in terms not only of oncological but also of functional outcomes.

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Medrobotics Flex transanal excision of a rectal gastrointestinal stromal tumour: first video of the transanal Flex robot used in a human – a video vignette

Cited by 16 publications

References 3 publications

Robotic-Assisted Transrectal Cholecystectomy in a Porcine Model

Robotic-Assisted Transrectal Cholecystectomy in a Porcine Model

Robotic-assisted surgical endoscopy: a new era for endoluminal therapies

Transanal TME: new standard or fad?

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