ArtiSential® vs. straight-stick in laparoscopic left-sided colorectal resection: a prospective randomized study

Area of Science:

• Minimally Invasive Surgery
• Colorectal Surgery
• Surgical Instrumentation

Background:

• Minimally invasive colorectal resections are standard surgical procedures.
• Conventional straight laparoscopic instruments are widely used.
• The efficacy of articulated instruments in these procedures requires evaluation.

Purpose of the Study:

• To compare the efficacy of articulated ArtiSential® instruments versus conventional straight laparoscopic instruments.
• To evaluate the primary endpoint of conversion to open laparotomy.
• To assess secondary endpoints including complications, blood loss, operating time, lymph node yield, and hospital stay.

Main Methods:

• A prospective randomized study involving 78 patients undergoing left-sided colorectal resections.
• Patients were randomized to receive either conventional (n=40) or ArtiSential® (n=38) instruments.
• Statistical analysis included Chi-square/Fisher's exact tests for categorical data and t-tests/Mann-Whitney U tests for continuous data, with a subgroup analysis for rectal resections.

Main Results:

• No significant differences in conversion rates or secondary endpoints were found in the overall cohort.
• In the rectal resection subgroup, ArtiSential® instruments were associated with significantly lower conversion rates (37.5% vs. 0%, p=0.036).
• The rectal resection subgroup also showed significantly reduced blood loss with ArtiSential® instruments (35.0 mL vs. 10.0 mL, p=0.017).

Conclusions:

• Articulated ArtiSential® instruments did not demonstrate overall benefits in left-sided colorectal resections.
• These instruments may offer advantages in rectal resections, specifically reducing conversion rates and blood loss.
• The findings suggest potential utility of articulated instruments in technically demanding minimally invasive colorectal procedures.