ArtiSential® Articulated Wrist-Like Instruments and Their First Application in Pediatric Minimally Invasive Surgery: Case Reports and Literature Review of the Most Commonly Available Robot-Inspired Devices

Abstract

Background: Robotic surgery is currently a reality in surgical practice, and many endeavors have been made to extend its application also in pediatric surgery. In the absence of easy access to a robotic surgical system, new devices have been developed to offer a valid alternative such as wristed instruments. These differ from conventional laparoscopic instruments owing to a wrist-like mechanism at the tip, which faithfully reproduces the movements of the surgeon’s hands, regaining more movement’s degrees; Methods: We present two case reports in which the patients were subjected to minimally invasive procedures with aid of wristed instruments, followed by a review of the literature regarding the devices commonly marketed; Results: Articulated or wristed instruments render the same features seen in robotic surgery, such as major dexterity in smaller spaces, restitution of more natural movements and the ability to get over obstacles in a direct visual line. Our center recently equipped with ArtiSential® articulated instruments and so far, they have proven to be of great value; Conclusions: wristed instruments could represent a standpoint for surgeons wanting to benefit from the advantages of robotic surgery with a cost-sensitive perspective.

Articulating forceps in laparoscopic total mesorectal excision: A video comparison with robotic surgery

“…[12][13][14] Their applications have also been observed in pediatric, cardiovascular, and thoracic surgeries. [15][16][17][18] In accordance with earlier studies, we found that articulated instruments could be managed almost identically to surgical robots during TMEs, leading to negligible differences between the two approaches.…”

Feasibility of articulating laparoscopic instruments in laparoscopic gastrectomy – a comparative study using propensity score matching

“…Thus current evidence shows that the use of articulating instruments in laparoscopic gastrectomy does not increase postoperative morbidity. With the start of these studies in laparoscopic gastrectomy, reports of the use of this device in other types of surgery such as colorectal [9][10][11], gynecological [12], and pediatric surgery [13] are increasing.…”

Feasibility of articulating laparoscopic instruments in laparoscopic gastrectomy using propensity score matching

“…Thus, current evidence shows that the use of articulating instruments in laparoscopic gastrectomy does not increase postoperative morbidity. With laparoscopic gastrectomy as a start, reports of the use of this device in other types of surgery such as colorectal 10 – 12 , gynecological 13 , and pediatric surgery 14 are increasing.…”