Comparative effectiveness of human scope assistant versus robotic scope holder in laparoscopic resection for...

Several types of robotic scope holders have been developed to date, but there are only some experimental reports or the results of small clinical cases. The Soloassist® system is a unique robotic scope holder with which the surgeon can control the field of view by a joystick. We evaluated the efficacy of Soloassist in laparoscopic resection for colorectal cancer.

We investigated operative time, blood loss, setup time, length of hospital stay, and the number of participating surgeons in 273 laparoscopic colorectal resections, including 130 cases with human assistant (HA group) and 143 cases with Soloassist (SA group). Additionally, we also used logistic regression of the perioperative factors for the propensity score calculation to balance the bias.

The number of participating surgeons was apparently less in the SA group (HA group: 3.3 vs. SA group: 2.5, p < 0.01). The average operative time was shorter in the SA group, but there was no statistical difference (HA group: 287.0 min vs. SA group: 268.5 min, p = 0.07). No significant difference was found in setup time, conversion rate, perioperative complications, and length of hospital stay. There was no conversion case to human scope assistant and no system-specific adverse event. Similar results were observed between two groups after propensity score matching.

Laparoscopic colorectal resection with Soloassist is safe and feasible. The present study demonstrated that Soloassist system provided the possibilities of saving human resources in laparoscopic colorectal resection without prolonged operative time or system-specific morbidity. Soloassist is an effective robot-assisted surgical instrument for colorectal surgery.