Comparison of robotic and laparoendoscopic single-site surgery systems in a suturing and knot tying task

Dan Eisenberg, Tamas J Vidovszky, James Lau, Bernadette Guiroy, Homero Rivas

Research output: Contribution to journalArticle

21 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)3182-3186
Number of pages5
JournalSurgical Endoscopy and Other Interventional Techniques
Volume27
Issue number9
DOIs
StatePublished - Sep 2013

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Robotics
Human Engineering
Nonparametric Statistics
Small Intestine
Volunteers
Swine
Surgeons

Keywords

  • da Vinci
  • Laparoscopy
  • LESS
  • Robot
  • Single-site surgery
  • Suturing

ASJC Scopus subject areas

  • Surgery

Cite this

Comparison of robotic and laparoendoscopic single-site surgery systems in a suturing and knot tying task. / Eisenberg, Dan; Vidovszky, Tamas J; Lau, James; Guiroy, Bernadette; Rivas, Homero.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 27, No. 9, 09.2013, p. 3182-3186.

Research output: Contribution to journalArticle

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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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