No data exists concerning the application of a new robotic system with 3-mm instruments (Senhance™, Transenterix, Milano, Italy) in small cavities. Therefore, the aim of this study was to test the ...system for its performance of intracorporal suturing in small boxes simulating small body cavities. Translucent plastic boxes of decreasing volumes (2519–90 ml) were used. The procedures (two single stitches, each with two consecutive surgical square knots) were performed by a system-experienced and three system-inexperienced surgeons in each box, starting within the largest box, consecutively exchanging the boxes into smaller ones. With this approach, the total amount of procedures performed by each surgeon increased with decreasing volume of boxes being operated in. Outcomes included port placement, time, task completion, internal and external instrument/instrument collisions and instrument/box collisions. The procedures could be performed in all boxes. The operating time decreased gradually in the first three boxes (2519–853 ml), demonstrating a learning curve. The increase of operating time from boxes of 599 ml and lower may be attributed to the increased complexity of the procedure in small cavities as in the smallest box with the dimensions of 2.9 × 6.3 × 4.9 cm. This is also reflected by the parallel increase of internal instrument–instrument collisions. With the introduction of 3-mm instruments in a new robotic surgical system, we were able to perform intracorporal suturing and knot tying in cavities as small as 90 ml. Whether this system is comparable to conventional three-port 3-mm laparoscopic surgery in small cavities—such as in pediatric surgery—has to be evaluated in further studies.
This prospective single-institutional clinical trial sought to assess the safety and feasibility of laparoscopic benign ovarian cyst enucleation with a novel robotic-assisted laparoscopic system. ...Here we report a series of 10 patients treated using the Telelap ALF-X system in the first clinical application on patients at the Division of Gynecologic Oncology, Catholic University of the Sacred Heart of Rome. The primary inclusion criterion was the presence of monolateral ovarian cyst without a preoperative assessment suspicious for malignancy. Intraoperative data, including docking time, operative time, estimated blood loss, intraoperative and perioperative complications, and conversion to either standard laparoscopy or laparotomy, were collected. The cysts were removed with an ovary-sparing technique with respect to conservative surgical principles. The median operative time was 46.3 minutes, and patients without postoperative complications were discharged at 1 or 2 days after the procedure. Telelap ALF-X laparoscopic enucleation of benign ovarian cysts with an ovary-sparing technique is feasible, safe, and effective; however, more clinical data are needed to determine whether this approach can offer any other benefits over other minimally invasive surgical techniques.
Aim
The use of robotic techniques in colorectal surgery is increasing. Recently, the Senhance™ surgical robotic system was introduced as a novel robotic platform designed to overcome some of the ...limits of standard laparoscopy. This study describes the initial, single‐center experience, evaluating feasibility and safety of the new robotic system in performing colorectal surgical procedures.
Methods
From June 2015 to November 2016, perioperative data of the first 45 patients who underwent robotic colorectal surgery with the Senhance™ surgical robotic system were collected and analysed. Indications for surgery included inflammatory bowel disease, colorectal cancer, endoscopically unresectable adenomas and complicated diverticular disease.
Results
The median age of patients was 57 (range: 18–92) years and the median body mass index (BMI) was 24 (range: 16–30) kg/m2. Surgical indications were colorectal cancer (66%), complicated inflammatory bowel disease (18%), diverticular disease (11%) and endoscopically unresectable adenoma (4.4%). The median operative time was 256 minutes, and the median docking time was 10.7 (range: 2–25) min. There were three conversions to standard laparoscopy and none to laparotomy. All patients operated on for malignancy (28 adenocarcinoma and 2 neuroendocrine tumours) underwent an appropriate oncological procedure. The median time to discharge was 5 (range: 3–19) days. The incidence of postoperative complications was 35.5% (Clavien–Dindo I/II, 14 patients; and Clavien–Dindo III, two patients). One patient was readmitted in the postoperative period. No patient required reoperation.
Conclusion
The results of this audit suggest that adoption of the Senhance™ surgical robotic system in colorectal surgery is feasible and safe. More clinical data are needed to determine whether this approach can offer any other benefits over other minimally invasive surgical techniques.
AbstractA new European telesurgical system, the Telelap Alf-x, is introduced. Its main features are individual arms, which enable free access to the patient throughout surgery, a large range of ...reusable surgical instruments, an open console with eye-tracking system, where the camera follows the eye and head movements of the surgeon, and the existing force feedback enables for the first time to feel the consistency of the tissues and avoid tearing of the stitches while suturing. The system combines the benefits of open surgery and endoscopy. The first clinical application, which involved 146 operations at the gynecological department of the Gemelli University Hospital in Rome, proved the safety and the surgical team's quick adaptation to the system.
Abstract A 53-yr-old woman presented with abdominal pain. Ultrasonography, computed tomography, and an endocrinologic work-up revealed a 4-cm nonfunctional left adrenal mass. A TriPort laparoscopic ...adrenalectomy was performed. The TriPort was inserted through a 3-cm subcostal incision. Using 5-mm instruments, a left adrenalectomy was performed. The specimen was dissected (harmonic scalpel) and extracted through a 10-mm bag. A TriPort adrenalectomy was successfully completed in 240 min (blood loss: 20 ml). The postoperative period was uneventful (discharge within 3 d). In our opinion, the TriPort adrenalectomy is feasible and safe, with favourable perioperative and short-term outcomes and a delighted patient at the 8-mo follow-up.
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