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Updated: Jan 12, 2026
Surgical Robot-Assisted Transanal Specimen Extraction Radical Sigmoidectomy Without an Auxiliary Abdominal Incision
Published on: June 13, 2025
Redefining surgical workflow efficiency: evaluation of a novel laparoscopic multi-tool prototype
Fabian Haak1, Hans-Michael Tautenhahn2, Uwe Scheuermann2
1Division of Hepatobiliary Surgery and Visceral Transplant Surgery, Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leibnizstraße 11, 04105, Leipzig, Germany. Fabian.haak@medizin.uni-leipzig.de.
Background:
Minimally invasive surgery improves patient outcomes but introduces ergonomic and workflow inefficiencies due to frequent instrument changes. Symphera GmbH developed a novel laparoscopic prototype enabling intracorporeal tool tip switching, aiming to enhance efficiency and reduce surgical interruptions.
Methods:
Seven experienced surgeons evaluated the prototype during standardized tasks using excised animal tissue in a simulated laparoscopic environment. The tasks assessed precision, ergonomics, and tool-switching functionality. Quantitative data were obtained by video analysis; qualitative insights were gathered via semi-structured interviews and a post-procedural questionnaire.
Results:
All participants completed the tasks successfully, with no safety concerns. A total of 148 tool changes were performed. The automated exchange sequence required a constant mechanical time of 2.6 s, with a median overall changing time of 3.4 s. A total of 148 tool changes were performed. Tool-changing errors occurred in 4.73% of the changes, and 6.08% of changes resulted in software errors that required reboots. Changing time had no significant impact on overall task duration. The precision of monopolar application was high, and all targets were accurately reached. Questionnaire responses rated tool exchange positively, while ergonomics were judged moderate; female participants highlighted weight and comfort limitations, reflecting gender-related differences in usability. Qualitative analysis revealed both device improvement needs and strong enthusiasm for its potential to streamline workflows and enhance surgical autonomy.
Conclusion:
The prototype was safe, functional, and well-received. While software instability and ergonomic refinements remain necessary, the system demonstrated feasibility for rapid intracorporeal tool switching and showed promise for reducing operative inefficiencies. Further technical development and clinical trials are warranted to establish its clinical and economic value.
