Robot-assisted Radical Prostatectomy with the Dexter Robotic System: Initial Experience and Insights into On-demand Robotics

Thillou, Damien; Robin, Humphrey; Ricolleau, Coline; Benali, N. Ali; Forgues, A.; Emeriau, Damien; Mignot, Hubert; Hugues, Guillaume

doi:10.1016/j.eururo.2023.05.034

Cited by 12 publications

(10 citation statements)

References 7 publications

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“…The remaining 59 studies included in our systematic review were noncomparative surgical series or case reports [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] .…”

Section: Resultsmentioning

confidence: 99%

Evaluation of Clinical Research on Novel Multiport Robotic Platforms for Urological Surgery According to the IDEAL Framework: A Systematic Review of the Literature

Ficarra,

Rossanese,

Giannarini

et al. 2024

European Urology Open Science

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Section: Resultsmentioning

confidence: 99%

Evaluation of Clinical Research on Novel Multiport Robotic Platforms for Urological Surgery According to the IDEAL Framework: A Systematic Review of the Literature

Ficarra,

Rossanese,

Giannarini

et al. 2024

European Urology Open Science

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“…However, there are still few significant benefits compared to conventional laparoscopic surgery, which has excellent operation time [16]. In addition, since the robot system is costly, an inexpensive laparoscopic holder that can be used in combination with conventional laparoscopic surgery must be developed [17].…”

Section: Discussionmentioning

confidence: 99%

“…However, they are limited by their size, weight, and price; therefore, further solutions are required for clinical applications. Various developments are being conducted [16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Development of an ICT Laparoscopy System with Motion-Tracking Technology for Solo Laparoscopic Surgery: A Feasibility Study

Lee,

Oh,

Kang

et al. 2024

Applied Sciences

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The increasing demand for laparoscopic surgery due to its cosmetic benefits and rapid post-surgery recovery is juxtaposed with a shortage of surgical support staff. This juxtaposition highlights the necessity for improved camera management in laparoscopic procedures, encompassing positioning, zooming, and focusing. Our feasibility study introduces the information and communications technology (ICT) laparoscopy system designed to aid solo laparoscopic surgery. This system tracks a surgeon’s body motion using a controller, manipulating an embedded camera to focus on specific surgical areas. It comprises a camera module, a camera movement controller, and a motor within the main body, operating connected wires according to controller commands for camera movement. Surgeon movements are detected by an inertial measurement unit (IMU) sensor, facilitating precise camera control. Additional features include a foot pedal switch for motion tracking, a dedicated trocar for main body stability, and a display module. The system’s effectiveness was evaluated using an abdomen phantom model and animal experimentation with a porcine model. The camera responded to human movement within 100 ms, a delay that does not significantly affect procedural performance. The ICT laparoscopy system with advanced motion-tracking technology is a promising tool for solo laparoscopic surgery, potentially improving surgical outcomes and overcoming staff shortages.

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“…However, for other procedure steps such as lateral to medial mobilization of the colon, omental release or splenic flexure takedown, the robot may be less mandatory and laparoscopy more suitable, since dissection is carried out in large spaces needing rapid navigation and frequent position changes. This mindset to offer both techniques during the same operation led to the concept of “on-demand” robotics, where both techniques can be interchangeably used during the same procedure [ 7 , 8 ].…”

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confidence: 99%

Feasibility of on-demand robotics in colorectal surgery: first cases

Hahnloser¹,

Rrupa²,

Grass³

2023

Surg Endosc

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Introduction The key benefits of robotics are improved precision and control, thanks to fully articulated robotic instruments and enhanced, stable endoscope control. However, colorectal procedures also require large movements such as medialization of the colon where a robotic platform is not always needed. We present the world’s first experience in colorectal surgery with a new open platform of on-demand robotics. Methods and procedures Standard laparoscopic 3-D camera, insufflator, trocars and energy devices, available in all hospitals performing laparoscopic surgery, are used in combination with the Dexter System™ from Distalmotion SA, which includes two robotic instrument arms, one robotic endoscope arm and a sterile surgeon console. We present the first 12 colorectal cases of robotic assisted ventral mesh rectopexy (n = 2), oncologic right colectomies (n = 8), transverse colectomy (n = 1) and ileocecal resection (n = 1) using the Dexter System. Results The two ventral mesh rectopexies were fully robotic, requiring no switching from standard laparoscopy to robotic assistance. The robotic platform was used for central vascular ligation (CVL) in all 8 oncologic colectomies, whereas medialization of the colon and transection was performed with standard laparoscopy. The switch from laparoscopy to robotics and back was performed in 15–30 s. Intracorporal anastomosis was performed in 4 patients (stapling by standard laparoscopy and suturing of the defect with robotic assistance). Conversion or permanent switch to standard laparoscopy was required in two patients due to visceral obesity. No robotic platform-related intraoperative adverse event occurred. No major morbidity occurred at 60 days. Conclusions On-demand robotics is feasible and combines the best of two worlds: Robotics where precision and enhanced dexterity are required and standard laparoscopy where it is at its best. The surgeon remains scrubbed-in at all times, allowing a switch between robotics and laparoscopy within seconds.

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Robot-assisted Radical Prostatectomy with the Dexter Robotic System: Initial Experience and Insights into On-demand Robotics

Cited by 12 publications

References 7 publications

Evaluation of Clinical Research on Novel Multiport Robotic Platforms for Urological Surgery According to the IDEAL Framework: A Systematic Review of the Literature

Evaluation of Clinical Research on Novel Multiport Robotic Platforms for Urological Surgery According to the IDEAL Framework: A Systematic Review of the Literature

Development of an ICT Laparoscopy System with Motion-Tracking Technology for Solo Laparoscopic Surgery: A Feasibility Study

Feasibility of on-demand robotics in colorectal surgery: first cases

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