Initial Experience With Single-Port Robotic Right Colectomies: Results of an Investigator-Initiated Investigational Device Exemption Study Using a Novel Single-Port Robotic Platform.

IF 3.2 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Diseases of the Colon & Rectum Pub Date : 2024-09-05 DOI:10.1097/dcr.0000000000003352
Ankit Sarin,Katherine E Barnes,Amy M Shui,Yukino Nakamura,Daniel B Hoffman,Fernanda Romero-Hernandez,Hueylan Chern
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Abstract

BACKGROUND Minimally invasive surgical techniques have been widely adopted in colorectal surgery. New technological breakthroughs have led to even less invasive alternatives like single-port surgery, but this has been hindered by technical challenges such as the collision of robotic arms within a limited space. The Intuitive da Vinci Single-Port robotic platform is a novel system that overcomes some of these challenges. IMPACT OF INNOVATION This study aimed to assess the safety and feasibility of the Intuitive da Vinci Single-Port robotic platform in right segmental colectomies among adult patients. These findings may set the stage for more widespread use of single-port robotic surgery. TECHNOLOGY, MATERIALS, AND METHODS The Intuitive da Vinci Single-Port robot is a system designed specifically for single-port robotic surgery. This platform enables flexible port location and efficient internal and external range of motion using a single C-shaped arm. In the present study, right colectomies were performed in adult patients using this platform between May 2022 and November 2022, and they were compared to right colectomies in adult patients performed using the standard multiport platform between January 2019 and December 2022. The main outcome measure was safety and quality event rates. PRELIMINARY RESULTS Of 30 patients, 16.7% of patients (n = 5) underwent single-port robotic right colectomy and 83.3% (n = 25) underwent multiport right colectomy. In the single-port group, 40% of patients (n = 2) developed a safety/quality event (postoperative portal vein thrombosis and excessive postoperative pain). In the multiport group, 32% of patients (n = 8) developed 1 safety/quality event and 8% (n = 2) had more than 1 event. CONCLUSIONS AND FUTURE DIRECTIONS This preliminary study, one of the first Food and Drug Administration-approved, investigator-initiated uses of this platform in colorectal surgeries, shows that this platform is a safe and feasible option for right colectomies. On preliminary evaluation, it appears comparable in terms of relevant safety/quality events to the multiport platform. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov NCT05321134.
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单孔机器人右结肠切除术的初步经验:使用新型单孔机器人平台的研究者发起的研究性设备豁免研究结果。
背景微创外科技术已在结直肠外科中广泛采用。新技术的突破带来了单孔手术等创伤更小的替代技术,但这一技术一直受到技术挑战的阻碍,例如机器人手臂在有限空间内的碰撞。本研究旨在评估直觉达芬奇单孔机器人平台在成年患者右段结肠切除术中的安全性和可行性。技术、材料和方法直观达芬奇单孔机器人是专为单孔机器人手术设计的系统。该平台可通过单个 C 形臂实现灵活的端口位置和高效的内外活动范围。在本研究中,2022 年 5 月至 2022 年 11 月期间,使用该平台为成年患者实施了右结肠切除术,并与 2019 年 1 月至 2022 年 12 月期间使用标准多孔平台为成年患者实施的右结肠切除术进行了比较。主要结果指标为安全性和质量事件发生率。初步结果 在30名患者中,16.7%的患者(n = 5)接受了单孔机器人右结肠切除术,83.3%的患者(n = 25)接受了多孔右结肠切除术。在单孔组中,40%的患者(n = 2)发生了安全/质量事件(术后门静脉血栓形成和术后过度疼痛)。结论和未来方向这项初步研究是经食品和药物管理局批准、由研究者发起在结直肠手术中使用该平台的首批研究之一,研究结果表明该平台是右结肠切除术中安全可行的选择。经初步评估,该平台在相关安全性/质量事件方面与多孔平台相当。
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来源期刊
CiteScore
4.50
自引率
7.70%
发文量
572
审稿时长
3-8 weeks
期刊介绍: Diseases of the Colon & Rectum (DCR) is the official journal of the American Society of Colon and Rectal Surgeons (ASCRS) dedicated to advancing the knowledge of intestinal disorders by providing a forum for communication amongst their members. The journal features timely editorials, original contributions and technical notes.
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