Robot‐assisted Fallopian tube transection and anastomosis using the new REVO‐I robotic surgical system: feasibility in a chronic porcine model

Abstract

ObjectivesTo evaluate the feasibility and safety of the new REVO-I robotic platform by performing Fallopian tube transection and anastomosis in live porcine models. Subjects and MethodsA prospective chronic animal study was carried out in four crossbred female pigs. The primary outcome was assessment of the pigs' 2-week survival. The secondary outcomes were measurements of intra-operative variables and the complications or difficulties arising when using the REVO-I. ResultsFallopian tube anastomosis was successfully performed in four porcine models. The mean (range) operating time was 66 (46-104 min), docking time 22.25 (14-53) min and console time 18 (13-20) min. The REVO-I robotic system functioned appropriately, with no technical problems or difficulties noted during the procedures. Both the surgeon and the bedside assistants reported ease of use and better performance with subsequent procedures. All pigs were alive 2 weeks after surgery, with no peri-operative complications related to the use of the robot. ConclusionsThis preclinical chronic porcine study showed that the REVO-I robotic surgical system is a feasible and safe robotic instrument that can be used by surgeons to perform skillful robotic procedures in porcine models. Our next objective will be to demonstrate its safety in humans.

New era of robotic surgical systems

“…The da Vinci system's closed console envelops the surgeon's face and can compromise the surgeon's awareness within the operating theater. In contrast, the Telelap ALF‐X and the newer Revo‐i, which is currently undergoing trials in Korea, offer open consoles that can improve operating ergonomics . The Telelap ALF‐X monitor requires the surgeon to wear 3‐D glasses and incorporates eye‐tracking, whereas Revo‐i has a 3‐D HD monitor .…”

“…The configuration of this model was designed to be similar to the da Vinci Surgical System. Abdel Raheem et al completed a preclinical study with porcine model in 2016 , and a clinical trial to treat patients with radical cholecystectomy or prostatectomy was performed by using this surgical system in 2017 . meerecompany obtained commercialized approval from the Korean Food and Drug Administration in August 2017.…”

“…Intuitive Surgical's intellectual property portfolio has no doubt played a significant part in helping the company to achieve and maintain its dominant position in the robotic surgery marketplace; it has laid a minefield of patent coverage that potential competitors must confront when evaluating the path to market entry. Several manufacturers are developing alternative robotic systems, but patents, particularly for clinical applications, are limited . In 2016, da Vinci's patents for the remote‐controlled robotic arms and tools and the surgical robot's imaging functionality expired.…”

Future of robotic surgery in urology

“…Intuitive Surgical currently owns >1500 patents (Appendix 1). Several manufacturers are developing alternative robotic systems (Figs ); however, because of issues related to patenting, in particular, their clinical applications remain limited . Nevertheless, the landscape of robotic surgery is expected to witness significant changes as new technologies might soon become available.…”

Human and robot: an amity not a discord

“…Asian countries like South Korea and China has also developed their own robotic system. Abdel Raheem et al (11) have reported their success in animal study using REVO I robot system (Meree company, Seoul, South Korea) and recently commenced with human trials. In China, Yi et al (12) reported safe and effective outcome of clinical cases utilizing Micro Hand S System.…”