AI Article Synopsis
- The study compares the performance of laparoendoscopic single-site (LESS) surgery and robotic single-site surgery in a suturing task using a porcine model.
- All participating surgeons could complete the suturing task with the robotic system on the first attempt, while only 60% could complete it with the LESS system after two tries.
- The robotic system showed significantly faster completion times and a 0% leak rate compared to the 90% leak rate observed with the LESS system, indicating a clear advantage for robotic assistance in complex surgical tasks.
Article Abstract
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.
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| http://dx.doi.org/10.1007/s00464-013-2874-y | DOI Listing |
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