ArtiSential® Clip Applier Use in Robotic Urologic Surgery: Initial Experience and Outcomes

Area of Science:

• Urologic Surgery
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Laparoscopic clip appliers are essential in urologic surgery.
• Existing tools may have limitations in articulation and precision.
• Novel instruments are needed to improve surgical outcomes.

Purpose of the Study:

• To evaluate the feasibility of the ArtiSential clip applier in robotic urologic surgery.
• To compare its performance against the standard Weck Hem-o-lok clip applier.
• To assess clip application accuracy and surgeon/assistant feedback.

Main Methods:

• Retrospective review of 100 robotic urologic surgeries (RALP, RARN, RAPN).
• Comparison of ArtiSential (Group 1) vs. Hem-o-lok (Group 2) clip appliers.
• Analysis of successful deployments, subjective assessments, and NASA-TLX for cognitive load.

Main Results:

• ArtiSential showed a higher success rate (97.1%) vs. Hem-o-lok (94.4%) (p < 0.05).
• Subjective accuracy was higher for ArtiSential (91.2% assistant, 89.1% surgeon) vs. Hem-o-lok (87.6% assistant, 83.2% surgeon).
• Mean NASA-TLX was higher for ArtiSential, with one lymphocele in the Hem-o-lok group.

Conclusions:

• The ArtiSential clip applier offers improved accuracy in robotic urologic surgery.
• Its double-jointed, multi-articulating design enhances precision over standard clip appliers.
• This technology shows promise for pelvic and retroperitoneal robotic procedures.