Laparoendoscopic single-site surgery using innovative articulating instruments: preclinical evaluation of the prototype.

Conventional articulating instruments for laparoendoscopic single-site (LESS) surgery have three major drawbacks: Weak articulating force, internal and external crowding, and mirror imaging and motion. The RoboHand™ is a recently developed novel articulating instrument. The goal of its development was to minimize the abovementioned three major drawbacks. In an ex vivo test, the joint force of the RoboHand was 2.5 to 3 times stronger than that of the LaparoAngle™ or the SILS™ instrument. In the porcine nephrectomy model, the operative times in the RoboHand group (28.8±6.6 min) were shorter than those in the LaparoAngle group (39.7±5.4 min), although not significant (P=0.146). The RoboHand prototype seems to be superior to other articulating laparoscopic instruments in its mechanical properties, such as joint force, and not to be clinically inferior to LaparoAngle for LESS. We describe the techniques for using this innovative instrument and discuss its advantages.