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Sakamoto Y, Itatani Y, Nishiyama K, Fujita Y, Hoshino N, Okamura R, Nishigori T, Hisamori S, Tsunoda S, Hida K, Obama K. Utility of articulating instruments as an alternative to robotic devices in laparoscopic right hemicolectomy. Int Cancer Conf J 2024; 13:78-82. [PMID: 38524662 PMCID: PMC10957826 DOI: 10.1007/s13691-024-00654-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/01/2024] [Indexed: 03/26/2024] Open
Abstract
Laparoscopic complete mesocolic excision with central vessel ligation has been widely accepted for its oncological benefits in colon cancer surgery. However, laparoscopic right hemicolectomy involves a risk for vascular injury during dissection around the surgical trunk. This technical difficulty has been attributed to the limited movement of conventional laparoscopic forceps. Although robotic devices can overcome the restricted motion of laparoscopic devices, they are not yet widely used. The ArtiSential is an articulating laparoscopic instrument that has a two-joint end-effector that enables a wide range of motion precisely reflecting the surgeon's finger movements, and is designed to compensate for the drawbacks of conventional laparoscopic tools. The present study demonstrated the utility of articulating instruments in laparoscopic right hemicolectomy by comparing the authors' laparoscopic procedures, using articulating instruments, with robotic procedures. Articulating laparoscopic instruments can be successfully maneuvered in virtually the same manner as robotic devices and, as such, represent a viable alternative to robotic surgery. Supplementary Information The online version contains supplementary material available at 10.1007/s13691-024-00654-w.
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Affiliation(s)
- Yusuke Sakamoto
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Yoshiro Itatani
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Kazuhiro Nishiyama
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Yusuke Fujita
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Nobuaki Hoshino
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Ryosuke Okamura
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Tatsuto Nishigori
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Shigeo Hisamori
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Shigeru Tsunoda
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Koya Hida
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Kazutaka Obama
- Department of Surgery, Graduate School of Medicine, Kyoto University, Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
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Kim IK, Lee CS, Bae JH, Han SR, Alshalawi W, Kim BC, Lee IK, Lee DS, Lee YS. Perioperative outcomes of laparoscopic low anterior resection using ArtiSential ® versus robotic approach in patients with rectal cancer: a propensity score matching analysis. Tech Coloproctol 2024; 28:25. [PMID: 38231341 DOI: 10.1007/s10151-023-02895-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/26/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Total mesorectal excision using conventional straight fixed devices may be technically difficult because of the narrow and concave pelvis. Several laparoscopic articulating tools have been introduced as an alternative to robotic systems. The aim of this study was to compare perioperative outcomes between laparoscopic low anterior resection using ArtiSential® and robot-assisted surgery for rectal cancer. METHODS This retrospective study included 682 patients who underwent laparoscopic or robotic low anterior resection for rectal cancer from September 2018 to December 2021. Among them, 82 underwent laparoscopic surgery using ArtiSential® (group A) and 201 underwent robotic surgery (group B). A total of 73 [group A; 66.37 ± 11.62; group B 65.79 ± 11.34] patients were selected for each group using a propensity score matching analysis. RESULTS There was no significant difference in the baseline characteristics between group A and B. Mean operative time was longer in group B than A (163.5 ± 61.9 vs 250.1 ± 77.6 min, p < 0.001). Mean length of hospital stay was not significantly different between the two groups (6.2 ± 4.7 vs 6.7 ± 6.1 days, p = 0.617). Postoperative complications, reoperation, and readmission within 30 days after surgery were similar between the two groups. Pathological findings revealed that the circumferential resection margins were above 10 mm in both groups (11.00 ± 7.47 vs 10.17 ± 6.25 mm, p = 0.960). At least 12 lymph nodes were sufficiently harvested, with no significant difference in the number harvested between the groups (20.5 ± 9.9 vs 19.7 ± 7.3, p = 0.753). CONCLUSIONS Laparoscopic low anterior resection using ArtiSential® can achieve acceptable clinical and oncologic outcomes. ArtiSential®, a multi-joint and articulating device, may serve a feasible alternative approach to robotic surgery in rectal cancer.
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Affiliation(s)
- I K Kim
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - C S Lee
- Department of Colorectal Surgery, Hansol Hospital, Seoul, Republic of Korea
| | - J H Bae
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S R Han
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - W Alshalawi
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Surgery, King Saud Medical City, Riyadh, Saudi Arabia
| | - B C Kim
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - I K Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - D S Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y S Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Jung Y, Hong JI, Han KN, Kim HK. Thoracoscopic anterior mediastinal mass removal using an articulating laparoscopic instrument. Interact Cardiovasc Thorac Surg 2021; 33:498. [PMID: 33880541 DOI: 10.1093/icvts/ivab110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/16/2021] [Accepted: 03/07/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Younggi Jung
- Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Jeong In Hong
- Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kook Nam Han
- Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hyun Koo Kim
- Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
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