The online version of this article (https://doi.org/10.1007/s00464-018-06658-x) contains supplementary material, which is available to authorized users.
This work was partly presented in the Emerging Technology iPoster Session of the 16th World Congress of Endoscopic Surgery, held at the Washington State Convention Center in Seattle, USA, April 11–14, 2018, jointly hosted by SAGES & CAGS.
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The Single Port Orifice Robotic Technology (SPORT) Surgical System by Titan Medical Inc. is designed to overcome the inherent challenges of minimally invasive single-access procedures. The aim of this preclinical study was to evaluate the feasibility of various digestive surgery procedures using this novel surgical robotic platform.
A total of 12 minimally invasive procedures were performed on six pigs (5 cholecystectomies, 3 Nissen fundoplications, 1 splenectomy and 1 hepatic pedicle dissection) and on one human cadaver (1 cholecystectomy and 1 Nissen fundoplication), by four laparoscopic surgeons. The usability of the device was assessed by means of the modified objective structured assessment of technical skills (OSATS) score that was calculated and analyzed by two independent observers on the recorded videos. Surgeon feedback and recommendations were systematically recorded.
All procedures were successfully completed with the SPORT system. In general, surgeons reported to appreciate the intuitive interface and controls, the high-resolution 3D imaging, the dexterity of the end-effectors, and the ergonomic open control platform. Some features requiring optimization were also identified. The modified OSATS score demonstrated a learning curve effect for all device-related tasks.
A variety of abdominal procedures could be safely completed with the current SPORT prototype, in the preclinical setting. This preliminary feasibility experience is promising and encourages further development of single-port robotically assisted surgery.
Video 1 Introduction of the CIT through the gel access port, connection of the CIT to the CU, and insertion of two multi-articulated instruments. (MP4 55915 KB)
Ross S, Rosemurgy A, Albrink M, Choung E, Dapri G, Gallagher S, Hernandez J, Horgan S, Kelley W, Kia M, Marks J, Martinez J, Mintz Y, Oleynikov D, Pryor A, Rattner D, Rivas H, Roberts K, Rubach E, Schwaitzberg S, Swanstrom L, Sweeney J, Wilson E, Zemon H, Zundel N (2012) Consensus statement of the consortium for LESS cholecystectomy. Surg Endosc 26:2711–2716 CrossRef
Janetschek G (2014) Robotics: will they give a new kick to single-site surgery? Eur Urol 66:1044–1045 CrossRef
Namdarian B, Dasgupta P (2018) What robot for tomorrow and what improvement can we expect? Curr Opin Urol 28:143–152
Diana M, Marescaux J (2015) Robotic surgery. Br J Surg 102:e15–e28 CrossRef
Nelson RJ, Chavali JSS, Yerram N, Babbar P, Kaouk JH (2017) Current status of robotic single-port surgery. Urol Ann 9:217–222 CrossRef
van der Linden YT, Brenkman HJ, van der Horst S, van Grevenstein WM, van Hillegersberg R, Ruurda JP (2016) Robotic single-port laparoscopic cholecystectomy is safe but faces technical challenges. J Laparoendosc Adv Surg Tech A 26:857–861 CrossRef
Bae SU, Jeong WK, Baek SK (2017) Robot-assisted colectomy for left-sided colon cancer: comparison of reduced-port and conventional multi-port robotic surgery. J Laparoendosc Adv Surg Tech A 27:398–403 CrossRef
Chan JYK, Wong EWY, Tsang RK, Holsinger FC, Tong MCF, Chiu PWY, Ng SSM (2017) Early results of a safety and feasibility clinical trial of a novel single-port flexible robot for transoral robotic surgery. Eur Arch Otorhinolaryngol 274:3993–3996 CrossRef
Kuo LJ, Ngu JC, Tong YS, Chen CC (2017) Combined robotic transanal total mesorectal excision (R-taTME) and single-site plus one-port (R-SSPO) technique for ultra-low rectal surgery-initial experience with a new operation approach. Int J Colorectal Dis 32:249–254 CrossRef
Lee S, Kim JK, Kim YN, Jang DS, Kim YM, Son T, Hyung WJ, Kim HI (2017) Safety and feasibility of reduced-port robotic distal gastrectomy for gastric cancer: a phase I/II clinical trial. Surg Endosc 31:4002–4009 CrossRef
Konstantinidis KM, Hirides P, Hirides S, Chrysocheris P, Georgiou M (2012) Cholecystectomy using a novel Single-Site((R)) robotic platform: early experience from 45 consecutive cases. Surg Endosc 26:2687–2694 CrossRef
Kilkenny C, Browne W, Cuthill IC, Emerson M, Altman DG, Group NCRRGW (2010) Animal research: reporting in vivo experiments: the ARRIVE guidelines. J Gene Med 12:561–563 CrossRef
Willems JI, Shin AM, Shin DM, Bishop AT, Shin AY (2016) A comparison of robotically assisted microsurgery versus manual microsurgery in challenging situations. Plast Reconstr Surg 137:1317–1324 CrossRef
Haueter R, Schutz T, Raptis DA, Clavien PA, Zuber M (2017) Meta-analysis of single-port versus conventional laparoscopic cholecystectomy comparing body image and cosmesis. Br J Surg 104:1141–1159 CrossRef
Li T, Kim G, Chang S (2016) Tips and tricks to avoid bile duct injury in SILC: an experience of 500 cases. Surg Endosc 30:4750–4755 CrossRef
- Enabling single-site laparoscopy: the SPORT platform
Jelle P. Ruurda
Konstantinos M. Konstantinidis
Lee L. Swanström
- Springer US
And Other Interventional Techniques
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