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Robotic-Assisted Transrectal Cholecystectomy in a Porcine Model.

Chi-Chung Foo1, Chung-Kwong Yeung2, Biji Sreedhar2

  • 11 University of Hong Kong, Queen Mary Hospital, Hong Kong, China.

Surgical Innovation
|February 14, 2019
PubMed
Summary

A new robotic system enables complex surgeries through natural openings, overcoming limitations of current minimally invasive techniques. This technology demonstrated feasibility in robotic-assisted transrectal cholecystectomy in pigs, showing promise for reduced surgical trauma.

Keywords:
NOTESsurgical robottransrectal cholecystectomy

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Robotics
  • Gastrointestinal Surgery

Background:

  • Single-incision laparoscopic surgery and Natural Orifice Transluminal Endoscopic Surgery (NOTES) aim to reduce surgical trauma but face challenges like instrument clashing and limited maneuverability.
  • A novel surgical robotic system was developed to address these limitations and enhance surgical capabilities.
  • The system is designed for high dexterity and single-port access, facilitating procedures through natural orifices.

Purpose of the Study:

  • To evaluate the feasibility of a novel surgical robotic system for performing robotic-assisted transrectal cholecystectomy in a porcine model.
  • To demonstrate the system's ability to overcome the limitations of existing minimally invasive surgical techniques.

Main Methods:

  • A novel, high-dexterity, single-access port robotic system with miniaturized, internally motorized arms (16 mm diameter, 7+ degrees of freedom) and a dual in vivo camera system was utilized.
  • Robotic-assisted transrectal cholecystectomy was performed in 3 adult male pigs using the novel system.
  • The system allows for intraabdominal and pelvic surgeries via natural orifices such as the rectum.

Main Results:

  • Robotic-assisted transrectal cholecystectomy was successfully completed in all 3 pigs with minimal estimated blood loss (<10 mL) and no intraoperative complications.
  • The robotic system provided surgeons with good dexterity, clear 3-dimensional vision, and adequate instrument spacing.
  • The system facilitated stable platform for transrectal insertion of robotic arms.

Conclusions:

  • The novel surgical robotic system is feasible for performing Natural Orifice Transluminal Endoscopic Surgery (NOTES) cholecystectomy.
  • The system offers a stable platform, enhanced dexterity, and clear visualization, potentially improving outcomes for transrectal procedures.
  • This technology represents a significant advancement in minimally invasive surgery, addressing previous technical challenges.