Abstract
BackgroundThe notion of articulation in surgery has been largely synonymous with robotics. The ARTISENTIAL® instruments aim at bringing advanced articulation to laparoscopy to overcome challenges in narrow anatomical spaces. In this paper, we present first single-center results of a series of low anterior resections, performed with ARTISENTIAL®.MethodsBetween September 2020 and August 2021, at the Department of Surgery, St. Marienkrankenhaus Siegen, Siegen, Germany, patients with cancer of the mid- and low rectum were prospectively enrolled in a pilot feasibility study to evaluate the ARTISENTIAL® articulated instruments in performing a laparoscopic low anterior resection. Perioperative and short-term postoperative data were analyzed.ResultsSeventeen patients (10 males/7 females) were enrolled in this study. The patients had a median age of 66 years (range 47–80 years) and a median body mass index of 28 kg/m2 (range 23–33 kg/m2). The median time to rectal transection was 155 min (range 118–280 min) and the median total operative time was 276 min (range 192–458 min). The median estimated blood loss was 30 ml (range 5–70 ml) and there were no conversions to laparotomy. The median number of harvested lymph nodes was 15 (range 12–28). Total mesorectal excision (TME) quality was ‘good’ in all patients with no cases of circumferential resection margin involvement (R0 = 100%). The median length of stay was 9 days (range 7–14 days). There were no anastomotic leaks and the overall complication rate was 17.6%. There was one unrelated readmission with no mortality.ConclusionsLow anterior resection with ARTISENTIAL® is feasible and safe. All patients had a successful TME procedure with a good oncological outcome. We will now seek to evaluate the benefits of ARTISENTIAL® in comparison with standard laparoscopic instruments through a larger study.
Highlights
Laparoscopy is considered the gold standard in colon surgery but there remains some skepticism of its role in rectal cancer due to the increased technical difficulty of operating within the narrow pelvis leading to suboptimal results [1, 2]
Some non-randomized studies that compared robotic surgery to standard laparoscopy reported improved clinical outcome in favor of robotics [8, 9]. This was mainly observed in terms of the conversionto-open rate, preservation of autonomic nerves as well as estimated blood loss (EBL) [10, 11]
This study describes the first experience of using ARTISENTIAL® in a larger cohort of patients undergoing a laparoscopic low anterior resection (LAR) with Total mesorectal excision (TME)
Summary
Laparoscopy is considered the gold standard in colon surgery but there remains some skepticism of its role in rectal cancer due to the increased technical difficulty of operating within the narrow pelvis leading to suboptimal results [1, 2]. Some non-randomized studies that compared robotic surgery to standard laparoscopy reported improved clinical outcome in favor of robotics [8, 9]. This was mainly observed in terms of the conversionto-open rate, preservation of autonomic nerves as well as estimated blood loss (EBL) [10, 11]. Two case reports with video vignettes reporting the clinical use of ARTISENTIAL® have already been published by our group [22, 23] The purpose of this single-center study was to evaluate the feasibility and safety of low anterior rectal resection performed with ARTISENTIAL®
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
