Expanding Robotic-Assisted Surgery in Gynecology Using the Potential of an Advanced Robotic System

Alkatout, Ibrahim; O’Sullivan, Odile; Peters, Göntje; Maass, Nicolai

doi:10.3390/medicina60010053

Cited by 3 publications

(1 citation statement)

References 71 publications

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“…Dexter consists of an open surgeon console, which can remain sterile, two patient carts with instrument arms, and one endoscope arm controlled from the surgeon console, accommodating any 3D-endoscopic system available on-site. Following its clinical approval in 2022, Dexter has been used in urology, general surgery, and gynaecology ( Alkatout et al, 2023 ; Böhlen and Gerber, 2023 ; Hahnloser et al, 2023 ; Thillou et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

The first robotic-assisted hysterectomy below the bikini line with the Dexter robotic system™

Alkatout,

Becker,

Nuhn

et al. 2024

Facts Views Vis ObGyn

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Background: Robotic-assisted hysterectomy (RAH) is a widely accepted minimally invasive approach for uterus removal. However, as RAH is typically performed in the umbilical region, it usually results in scars in cosmetically suboptimal locations. This is the first case of RAH with cervicosacropexy performed below the bikini line, using the new Dexter robotic system™. Objectives: The aim of this article is to show the surgical steps of the first RAH with cervicosacropexy performed below the bikini line with the new Dexter robotic system™ (Distalmotion), and furthermore assess the feasibility of this approach using this robotic platform. Materials and methods: A 43-year-old woman with uterine adenomyosis and recurrent uterine prolapse underwent a robotic-assisted subtotal hysterectomy with cervicosacropexy, performed below the bikini line, using the Dexter robotic system™, at the Clinic of Gynecology and Obstetrics at Universitätsklinikum Schleswig-Holstein (UKHS) in Kiel, Germany. Main outcome measures: Perioperative data, surgical approach specifics, objective, and subjective outcomes of this new approach. Results: The procedure was performed without intra-operative complications; estimated blood loss was 10 ml. Operative time was 150 minutes, console time 120 minutes, total docking time 6 minutes. Dexter performed as expected; no device-related issues or robotic arm collisions occurred. The patient did not require pain medication and was released on the second postoperative day. Conclusion: RAH performed below the bikini line using the Dexter robotic system™ is a feasible, safe, and adequate procedure. These initial results should be confirmed and further extensively refurbished with larger patient cohorts, and functional and psychological outcomes need further investigation.

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Section: Introductionmentioning

confidence: 99%

The first robotic-assisted hysterectomy below the bikini line with the Dexter robotic system™

Alkatout,

Becker,

Nuhn

et al. 2024

Facts Views Vis ObGyn

View full text Add to dashboard Cite

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Evaluation of the benefit of indocyanine green as an educational and practical tool for ureteral identification in laparoscopic pelvic surgery: a cross-sectional study

Ramadan,

Etrusco,

D’Amato

et al. 2024

Minimally Invasive Therapy & Allied Technologies

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The Combination of Laparoscopic and Robotic Surgery: First Experience with the Dexter Robotic System™ in Visceral Surgery

Conrad,

Mehdorn,

Alkatout

et al. 2024

Life

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Introduction: For over two decades, abdominal surgical procedures have been safely performed robotically. After the first patent expiration, alternative robotic systems entered the market. The Dexter Robotic System™ is a small-format, modular, and robotic platform consisting of a surgeon’s console, two patient carts with instrument arms, and one endoscope arm. We report our initial experiences with Dexter since its installation at our visceral surgery department. Methods: The system and surgical setup are described. Demographic and perioperative data of all operated patients as well as the system docking times were analyzed. Results: From 56 procedures performed with Dexter, the most common ones included cholecystectomy (n = 15), inguinal hernia repair (TAPP; unilateral n = 15; bilateral n = 3), and right oncologic hemicolectomy (n = 15). The median docking time was 6 min (2–16 min) and was reduced to 4 min in the last tertile of procedures performed. Conclusions: In our experience, Dexter can be implemented without any major challenges, and visceral surgical procedures of simple to medium complexity can be performed safely. The simplicity and accessibility of the system along with the ease of switching between robotics and laparoscopy could be particularly suitable for beginners in robotic surgery

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Expanding Robotic-Assisted Surgery in Gynecology Using the Potential of an Advanced Robotic System

Cited by 3 publications

References 71 publications

The first robotic-assisted hysterectomy below the bikini line with the Dexter robotic system™

The first robotic-assisted hysterectomy below the bikini line with the Dexter robotic system™

Evaluation of the benefit of indocyanine green as an educational and practical tool for ureteral identification in laparoscopic pelvic surgery: a cross-sectional study

The Combination of Laparoscopic and Robotic Surgery: First Experience with the Dexter Robotic System™ in Visceral Surgery

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