Robotically assisted minimally invasive biliary surgery in a porcine model.

Area of Science:

• Minimally Invasive Surgery
• Surgical Robotics
• Biliary Tract Surgery

Background:

• Robotic surgery systems offer potential benefits like reduced tremor and enhanced dexterity for complex endosurgical tasks.
• A prospective study was conducted to evaluate robotically assisted minimally invasive biliary surgery.
• The Zeus robotic surgical system was utilized in a porcine model.

Purpose of the Study:

• To assess the feasibility and safety of robotically assisted minimally invasive biliary surgery.
• To evaluate the Zeus system's effectiveness in complex biliary procedures.
• To determine the system's impact on dexterity and precision in laparoscopic surgery.

Main Methods:

• The study involved 16 domestic swine (50 kg) undergoing robotically assisted cholecystectomy.
• Procedures included common bile duct incision, T-tube placement, and suture repair.
• Retrieval of simulated bile duct calculi and 6-week postoperative monitoring with liver function tests and cholangiography were performed.

Main Results:

• Median setup time was 45 minutes; operative times for cholecystectomy and bile duct repair were 40 and 80 minutes, respectively.
• 11 out of 12 simulated bile duct calculi were successfully retrieved.
• Postoperative cholangiography showed no leaks, and liver function tests remained normal. Anastomotic stenotic index was 0.98 at 6 weeks.

Conclusions:

• Robotically assisted minimally invasive biliary surgery is feasible and safe in this animal model.
• The Zeus system enhances dexterity, enabling precise laparoscopic suture repair of small bile ducts.
• This technology holds promise for improving outcomes in complex minimally invasive biliary procedures.