Abstract

As an alternative to the surgical robot, some medical companies have engineered new steerable devices that mimic the robot’s capacities. This study aimed to assess how steerable instruments ameliorate the efficacy of suturing in comparison with the traditional instrument, and a combination instruments, performed by experienced and novice surgeons. The study was performed by three experienced surgeons and three novice surgeons. The instruments employed were divided into three surgical sets: two steerable dissectors; one steerable dissector and one straight needle; two straight needle holders. The study supervisor recorded the total time for the procedure, the number of bites completed, the time for each bite, and the quality of the procedure. In our study, we found consistent data demonstrating that experienced laparoscopists completed the prescribed suture pattern with more bites in less time than novices. The use of two steerable instruments was more time consuming than standard straight instruments, but a combination of instruments was significantly less time consuming, as was the use of two straight needle holders. This result was even observed in novice surgeons. Combining a steerable instrument with a traditional straight needle holder provided more advantages in this study.

Highlights

  • Surgical robots were introduced into human surgical procedures in the late 1990s to overcome the limits of conventional laparoscopy, including difficulties with dexterity and challenges [1].Among the various features of robotic surgical systems, the stereoscopic vision, wristed instruments, and tremor filtration are considered to improve performance on laparoscopic tasks [2].Robotic surgery was currently largely employed in many surgical specialties, in particular in urologic procedures [3]

  • The number of bites completed with the Laproflex instruments was 3.71 ± 1.60 (IQR 4.00–5.00; 95% confidence interval (95% CI) 2.22–5.20), 5.75 ± 1.83 (IQR 4.225–7.75; 95% CI 4.35–7.14) with the combination of instruments, and 4.45 ± 2.11 (IQR 3.00–6.00; 95% CI 3.35–5.73) for the straight instruments

  • This study aimed to assess the role of steerable laparoscopic instruments in performing basic suture tasks by experienced laparoscopists and novice surgeons, comparing straight instruments and a combination of a steerable instrument and a straight needle holder

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Summary

Introduction

Surgical robots were introduced into human surgical procedures in the late 1990s to overcome the limits of conventional laparoscopy, including difficulties with dexterity and challenges [1]. Robotic surgery was currently largely employed in many surgical specialties, in particular in urologic procedures [3]. Robotic surgery offers a faster learning curve, especially regarding suture techniques [4,5,6], with the presumably shared benefits of laparoscopy including less perioperative morbidity, improved visibility and precision, and faster recovery. The disadvantages of the robotic approach include the cost of the device [7] and the fact that they are not currently available in veterinary medicine. In the last fifteen years, there has been substantial interest in creating devices that can provide some of the advantages of surgical robots, but at a lower cost.

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