BACKGROUND: Laparoendoscopic single-site (LESS) surgery has been established for various procedures. Shortcomings of LESS surgery include loss of triangulation, instrument collisions, and poor ergonomics, making advanced laparoscopic tasks especially challenging. We compared a LESS system with a robotic single-site surgery platform in performance of a suturing and knot-tying task under clinically simulated conditions. METHODS: Each of five volunteer minimally invasive surgeons was tasked with suturing a 5 cm longitudinal enterotomy in porcine small intestine with square knots at either end, using a laparoendoscopic or da Vinci robotic single-site surgery platform, within a 20 min time limit. A saline leak test was then performed. Each surgeon performed the task twice using each system. The time to completion of the task and presence of a leak were noted. Fisher's exact test was used to compare the overall completion rate within the defined time limit, and a Wilcoxon rank test was used to compare the specific times to complete the task. A p value of <0.05 was considered significant. RESULTS: All surgeons were able to complete the task on the first try within 20 min using the robot system; 60% of surgeons were able to complete it after two attempts using the LESS surgery system. Time to completion using the robot system was significantly shorter than the time using the standard LESS system (p < 0.0001). There were no leaks after closure with the robot system; the leak rate following the standard LESS system was 90%. CONCLUSIONS: Surgeons demonstrated significantly better suturing and knot-tying capabilities using the robot single-site system compared to a standard LESS system. The robotic system has the potential to expand single-site surgery to more complex tasks.
BACKGROUND: Laparoendoscopic single-site (LESS) surgery has been established for various procedures. Shortcomings of LESS surgery include loss of triangulation, instrument collisions, and poor ergonomics, making advanced laparoscopic tasks especially challenging. We compared a LESS system with a robotic single-site surgery platform in performance of a suturing and knot-tying task under clinically simulated conditions. METHODS: Each of five volunteer minimally invasive surgeons was tasked with suturing a 5 cm longitudinal enterotomy in porcine small intestine with square knots at either end, using a laparoendoscopic or da Vinci robotic single-site surgery platform, within a 20 min time limit. A saline leak test was then performed. Each surgeon performed the task twice using each system. The time to completion of the task and presence of a leak were noted. Fisher's exact test was used to compare the overall completion rate within the defined time limit, and a Wilcoxon rank test was used to compare the specific times to complete the task. A p value of <0.05 was considered significant. RESULTS: All surgeons were able to complete the task on the first try within 20 min using the robot system; 60% of surgeons were able to complete it after two attempts using the LESS surgery system. Time to completion using the robot system was significantly shorter than the time using the standard LESS system (p < 0.0001). There were no leaks after closure with the robot system; the leak rate following the standard LESS system was 90%. CONCLUSIONS: Surgeons demonstrated significantly better suturing and knot-tying capabilities using the robot single-site system compared to a standard LESS system. The robotic system has the potential to expand single-site surgery to more complex tasks.
Authors: Dimitrios Stefanidis; William W Hope; James R Korndorffer; Sarah Markley; Daniel J Scott Journal: J Am Coll Surg Date: 2010-04 Impact factor: 6.113
Authors: Aziz M Merchant; Michael W Cook; Brent C White; S Scott Davis; John F Sweeney; Edward Lin Journal: J Gastrointest Surg Date: 2008-10-30 Impact factor: 3.452
Authors: Inderbir S Gill; Arnold P Advincula; Monish Aron; Jeffrey Caddedu; David Canes; Paul G Curcillo; Mihir M Desai; John C Evanko; Tomasso Falcone; Victor Fazio; Matthew Gettman; Andrew A Gumbs; Georges-Pascal Haber; Jihad H Kaouk; Fernando Kim; Stephanie A King; Jeffrey Ponsky; Feza Remzi; Homero Rivas; Alexander Rosemurgy; Sharona Ross; Philip Schauer; Rene Sotelo; Jose Speranza; John Sweeney; Julio Teixeira Journal: Surg Endosc Date: 2009-12-09 Impact factor: 4.584
Authors: Sharona Ross; Alexander Rosemurgy; Michael Albrink; Edward Choung; Giovanni Dapri; Scott Gallagher; Jonathan Hernandez; Santiago Horgan; William Kelley; Michael Kia; Jeffrey Marks; Jose Martinez; Yoav Mintz; Dmitry Oleynikov; Aurora Pryor; David Rattner; Homero Rivas; Kurt Roberts; Eugene Rubach; Steven Schwaitzberg; Lee Swanstrom; John Sweeney; Erik Wilson; Harry Zemon; Natan Zundel Journal: Surg Endosc Date: 2012-08-31 Impact factor: 4.584
Authors: Ivy N Haskins; Andrew T Strong; Matthew T Allemang; Kalman P Bencsath; John H Rodriguez; Matthew D Kroh Journal: Surg Endosc Date: 2017-07-21 Impact factor: 4.584
Authors: Anthony Yuen Bun Teoh; Shannon Melissa Chan; Hon Chi Yip; Vivien Wai Yin Wong; Philip Wai Yan Chiu; Enders Kwok Wai Ng Journal: Surg Endosc Date: 2017-08-11 Impact factor: 4.584
Authors: Omar F Dueñas-Garcia; Gina M Sullivan; Katherine Leung; Kristen L Billiar; Michael K Flynn Journal: Int Urogynecol J Date: 2017-06-20 Impact factor: 2.894
Authors: Gaby N Moawad; Paul Tyan; Jiheum Paek; Erryn E Tappy; Daniel Park; Souzanna Choussein; Serene S Srouji; Antonio Gargiulo Journal: J Robot Surg Date: 2019-01-21
Authors: Homero Rivas; Ignacio Robles; Francisco Riquelme; Marcelo Vivanco; Julio Jiménez; Boris Marinkovic; Mario Uribe Journal: Ann Surg Date: 2018-01 Impact factor: 12.969