Primarily Gasless Robot-Assisted Cholecystectomy in Dogs: A Cadaveric Feasibility Study

Area of Science:

• Veterinary Surgery
• Minimally Invasive Techniques
• Robotic Surgery

Background:

• Gallbladder disease is common in dogs, with cholecystectomy as a definitive treatment.
• Minimally invasive surgery offers benefits but faces challenges like technical complexity and CO₂ pneumoperitoneum effects.
• Current limitations hinder the widespread adoption of advanced surgical techniques in canine patients.

Purpose of the Study:

• To evaluate the feasibility of a primarily gasless robot-assisted cholecystectomy using abdominal wall suspension in canine cadavers.
• To assess the technical aspects and safety of this novel approach.
• To establish a foundation for future in vivo studies.

Main Methods:

• A gasless robot-assisted cholecystectomy was performed on five canine cadavers using abdominal wall suspension and the Versius™ robotic platform.
• A normobaric operative field was maintained, with CO₂ insufflation used only as a rescue maneuver.
• Feasibility was assessed by operative time, visualization quality, and intraoperative events.

Main Results:

• All procedures were successfully completed in the canine cadavers.
• Three procedures were performed entirely without CO₂ insufflation.
• Adequate or optimal visualization of the hepatocystic triangle was achieved in all cases, with no intraoperative injuries.
• Two procedures required brief, low-pressure CO₂ insufflation as a rescue maneuver.

Conclusions:

• A primarily gasless robot-assisted cholecystectomy is technically feasible in a canine cadaveric model.
• This approach shows promise for reducing physiological stress associated with traditional CO₂ pneumoperitoneum.
• Further in vivo studies are needed to confirm safety and efficacy in live animals.