In:
Journal of Hepato-Biliary-Pancreatic Sciences, Wiley, Vol. 18, No. 4 ( 2011-07), p. 493-498
Abstract:
Minimally invasive surgery including laparoscopic and robotic surgery was recently approved for clinical use in hepatobiliary surgery. The purpose of this article is to evaluate the feasibility and technical aspects of robotic single incision for hepatobiliary surgery using the GelPort laparoscopic system in a preliminary animal study. Methods We performed eight robotic single‐incision laparoscopic surgery (SILS) procedures, including four cholecystectomies and four lateral segmentectomy of the liver, in a porcine study using the da Vinci S‐HD Surgical System. A single‐channel GelPort access was placed through a 2.5‐cm single incision for robotic access. A 12‐mm camera port, two 8‐mm ports for the robotic arms and one 5‐mm port for the patient‐side assistant were inserted. A Mini Loop Retractor was applied to retract the fundus of the gallbladder. The EndoWrist dissector and grasping forceps was introduced to fine‐dissect Calot's triangle. The instruments were crossed to avoid “sword fighting” and clashing of instruments in the abdomen. The cystic duct was divided after double ligation and the gallbladder was removed. Hepatic transection was performed with bipolar Harmonic shears and LigaSure for vascular pedicles. Results All robotic SILS procedures were completed (8/8, 100%). The cholecystectomies and hepatectomies were safely performed in average operating times of 70 min (±15) and 60 min (±20), respectively, with minimal blood loss. There were no conversions, re‐interventions or extension of the skin incision. Conclusions Robotic hepatobiliary SILS is technically feasible and safe using GelPort as a single‐incision access platform. Robotic SILS is becoming established and is enormously advantageous to the patient.
Type of Medium:
Online Resource
ISSN:
1868-6974
,
1868-6982
DOI:
10.1007/s00534-011-0387-4
Language:
English
Publisher:
Wiley
Publication Date:
2011
detail.hit.zdb_id:
2536390-6
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