Initial Experience With a New Robotic Surgical System for Cholecystectomy

Abstract

Background. Laparoscopic cholecystectomy has been the gold standard treatment for symptomatic cholelithiasis for more than 3 decades. Robotic techniques are gaining traction in surgery, and recently, the Senhance™ robotic system was introduced. The system offers advantages over other robotic systems such as improved ergonomics, haptic feedback, eye tracking, and usability of standard laparoscopic trocars and reusable instruments. The Senhance was evaluated to understand the feasibility, benefits, and drawbacks of its use in cholecystectomy. Study Design. A prospectively maintained database of the first 20 patients undergoing cholecystectomy with the Senhance was reviewed at a single hospital. Data including operative time, console time, set up time, and adverse events were collected, with clinical outcome and operative time as primary outcome measures. A cohort of 20 patients having laparoscopic cholecystectomy performed by the same surgeon was used as a comparator group. Results. The 2 groups had comparable demographic data (age, sex, and body mass index). In the Senhance group, 19 of the 20 procedures (95%) were completed robotically. The median (interquartile range) total operating, docking, and console times were 86.5 (60.5-106.5), 11.5 (9-13), and 30.8 (23.5-35) minutes, respectively. In the laparoscopic group, the median (interquartile range) operating time was 31.5 (26-41) minutes. Postoperatively, only one patient had a surgical complication, namely a wound infection treated with antibiotics. Conclusion. Our results suggest that Senhance-assisted cholecystectomy is safe, feasible, and effective, but currently has longer operative times. Further prospective and randomized trials are required to determine whether this approach can offer any other benefits over other minimally invasive surgical techniques.

Intraoperative and postoperative outcomes of robot-assisted cholecystectomy: a systematic review

“…We attempted to control for this variable by only including studies after 2010; however, it is possible that some of the data remain influenced by this factor. Indeed, while 90% of the reviewed studies acknowledged the possibility of a learning curve, only five reported data and assessment on these trends [14,19,26,50,55]. The learning curve also applies to the OR staff's setup and takedown of the robot unit and to the flow of the operation.…”

“…Three groups were formed to address this. The first included studies that compared techniques using the same number of ports (seven compared techniques with multi-ports [14,15,23,32,43,44,57]; 12 compared techniques with single ports [18, 20, 26-28, 34, 41, 45, 50, 53, 56, 58]), and of these, two were RCTs [27,32], and one was a propensity-matched analysis [43]. The second group included those comparing single-port robot-assisted with multi-port laparoscopic cholecystectomy (12 studies [13,19,22,29,30,38,40,42,46,54,55,59], including two RCTs [38,46] and one propensity-matched analysis [30]).…”

An early experience with the Senhance surgical robotic system in colorectal surgery: a single‐institute study

“…Since the initial reports of the use of the Senhance robotic platform in gynaecology 9 and colorectal surgery, 7 subsequent studies have confirmed the safety and feasibility of this system in abdominal procedures, [10][11][12][13] including colorectal surgeries. [14][15][16][17][18] In addition, previous publications have demonstrated its economic advantage over other systems for hysterectomy.…”

Short‐term results of robot‐assisted colorectal cancer surgery using Senhance Digital Laparoscopy System

“…The recently introduced Senhance surgical robotic system can transmit haptic feedback to the surgeon, and provides an eye‐tracking camera control system, operator comfort, and reusable endoscopic instruments that enable starting the surgery with uncomplicated and highly standardized procedures. This system has already been used clinically in Europe and the United States, and there have been reports of its use in many surgical procedures, including colorectal cancer surgery 2–6 . However, it has only been introduced at four institutions in Japan, including our hospital.…”