The effectiveness and safety of robot assisted laparoscopic colorectal surgery by da Vinci Si Surgical System.
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ABSTRACT:
DISEASE(S): Colorectal Cancer
PROVIDER: 2632340 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
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Project description:PurposeThis study aims (1) to investigate the feasibility of robot-assisted penetrating keratoplasty (PK) using the new Da Vinci Xi Surgical System and (2) to report what we believe to be the first use of this system in experimental eye surgery.MethodsRobot-assisted PK procedures were performed on human corneal transplants using the Da Vinci Xi Surgical System. After an 8-mm corneal trephination, four interrupted sutures and one 10.0 monofilament running suture were made. For each procedure, duration and successful completion of the surgery as well as any unexpected events were assessed. The depth of the corneal sutures was checked postoperatively using spectral-domain optical coherence tomography (SD-OCT).ResultsRobot-assisted PK was successfully performed on 12 corneas. The Da Vinci Xi Surgical System provided the necessary dexterity to perform the different steps of surgery. The mean duration of the procedures was 43.4 ± 8.9 minutes (range: 28.5-61.1 minutes). There were no unexpected intraoperative events. SD-OCT confirmed that the sutures were placed at the appropriate depth.ConclusionsWe confirm the feasibility of robot-assisted PK with the new Da Vinci Surgical System and report the first use of the Xi model in experimental eye surgery. Operative time of robot-assisted PK surgery is now close to that of conventional manual surgery due to both improvement of the optical system and the presence of microsurgical instruments.Translational relevanceExperimentations will allow the advantages of robot-assisted microsurgery to be identified while underlining the improvements and innovations necessary for clinical use.
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Project description:Interventions: A robot assisted operation using ‘da Vinci Xi’ period of ntervention: 5 years
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Project description:BackgroundRobot-assisted surgery is considered to improve ergonomics over standard endoscopic surgery. Nevertheless, previous research demonstrated ergonomic deficits in the current console set-up.AimThis study was designed to objectively assess body posture in the da Vinci console during robot-assisted endoscopic surgery.MethodsMultiple sagittal photographs from six physicians were taken during robot-assisted procedures. Trunk, neck, shoulder, elbow, hip, and knee angles were calculated and compared to ergonomic preferable joint angles. A 2D geometric model was developed using individual anthropometrics. Optimal seat height, armrest height, and viewer height were calculated. These results were compared to the findings of the sagittal photographs.ResultsMean joint angles show potentially harmful neck angles for all participants. Trunk angles vary between surgeons, from inadequate to correct. In short and very tall individuals, optimal armrest height is outside the adjustment range of the console.ConclusionThe da Vinci Surgical System console seating position results in a nonergonomic neck and trunk angle. The developed geometric model revealed that armrest height has a limited adjustment range. Adjustments to the console and optimization of preoperative settings are goals to further improve ergonomics in robot-assisted surgery.
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Project description:IntroductionRobotic single-port platforms represent a viable option for advanced surgical procedures. This preclinical study investigated the dual-field, single-port, robot-assisted transanal total mesorectal excision (taTME).TechniqueIn a male human cadaver, we employed the novel da Vinci® SP™ Surgical System, sequentially, to realize the transanal and abdominal parts of the taTME procedure. We evaluated the feasibility of the one-team approach.ResultsWe showed that single-port access for the taTME was technically feasible with the current da Vinci® SP™ Surgical System in both surgical fields. The total console times were 189 min for the juxta-anal purse-string suture placement, partial intersphincteric resection, and bottom-up mesorectal dissection to where it meets the peritoneal reflection and 43 min for the abdominal procedure. A good quality specimen was achieved. The surgeon comfort was high during simulated surgery. The task load was highly acceptable (NASA-TLX global score: 35), even though it was the surgeon's first use of this platform.ConclusionThis preclinical study demonstrated that the robotic, single-port taTME was feasible and could be performed with the da Vinci® SP™ Surgical System, beginning at the level of the dentate line. Further simulations are necessary to confirm this promising approach.
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Project description:Interventions: The colorectal cancer operation by the robot-assisted surgery using the da Vinci Si operation system 30 cases
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Project description:PurposeLaparoendoscopic single-site surgery (LESS) reduces the limited invasiveness of conventional laparoscopy while providing superior cosmetic results. However, LESS remains a challenging surgical technique, even in robotic surgery, primarily due to the lack of triangulation and limited instrument movement. The da Vinci SP surgical system (Intuitive Surgical) was recently introduced to overcome these limitations. We describe our initial experience with pure single-site robot-assisted pyeloplasty (RAP) for ureteropelvic junction obstruction (UPJO) using the da Vinci SP surgical system.Materials and methodsThree consecutive patients who were diagnosed with UPJO underwent RAP with the da Vinci SP surgical system from December 2018 to February 2019 at our institution. The surgical technique involved reproducing the steps of multi-port RAP. A 30-mm umbilical incision was made and the GelPOINT was inserted. The multichannel robotic port and the assistant's port were placed through the GelSeal cap. In all patients, Anderson-Hynes dismembered pyeloplasty was performed. The ureteral double J stent was inserted antegrade, and the drain was not placed.ResultsThe procedures were successfully completed using a pure single-site approach. There was no need for additional port placement or conversion to laparoscopic or open surgery. Total operative time in the three patients was 139, 180, and 213 minutes, respectively. No intraoperative complications occurred, and blood loss was minimal. The postoperative course of all patients was uneventful with no complications greater than Clavien-Dindo grade I surgical complications.ConclusionsPure single-site RAP using the da Vinci SP surgical system is feasible and safe.
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