Single-port laparoscopic appendectomy for perforated appendicitis using ArtiSential® wristed articulated instrument

Abstract

Single-port laparoscopic appendectomy (SPLA) was firstly introduced in 1998 and has been suggested potential advantages including better cosmetic outcome, less post-operative pain and avoidance of possible haemorrhagic complications from injuring epigastric vessels. However, single-port laparoscopic approach using conventional straight instruments may lead to internal and external conflicts and ergonomic discomfort, and new laparoscopic articulating instruments were developed to overcome these limitations of straight instruments. The ArtiSential ® (LIVSMED Inc., Republic of Korea) is an 8-mm diameter pistol-handle instrument that has complete articulating function like human wrist and intuitive controllability. We present a technical report of SPLA for perforated appendicitis using ArtiSential ® wristed articulated instrument. A 78-year-old female with a body mass index of 23.5 was referred to our emergency room with right lower quadrant abdominal pain. Abdominal computed tomography scan showed a distended tubular structure in the right lower quadrant (1.2 cm in diameter) with periappendiceal fluid collection. The patient’s clinical presentation was highly indicative of perforated acute appendicitis. We performed SPLA with ArtiSential ® grasper with the left hand, and this instrument helped us to allow greater manoeuvrability and dexterity with double triangulation technique. The total operation time was 40 min, and the patient was discharged without complications on the 1 st day after surgery.

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

“…The ArtiSential has been utilized in gastrointestinal surgery, specifically for gastrectomy, 7,8 appendectomy, 9 right hemicolectomy, 10 and transverse colectomy 11 . Similarly, rectal surgery using these forceps has been increasingly reported 12–14 .…”

Feasibility of articulating laparoscopic instrument use in laparoscopic adnexectomy: a multicenter prospective observational study

“…This instrument features a multi-joint mechanism akin to robotic surgery implements, enabling flexible and ergonomic movement that enhances surgical precision and efficiency ( 9 ). While articulating instruments have been explored in various surgical fields ( 10 - 13 ), their utility in gynecologic surgery, particularly in laparoscopic adnexectomy, remains poorly understood. This study aims to present the safety and feasibility of laparoscopic adnexectomy using an articulating laparoscopic instrument.…”

Myomectomy with ArtiSential fully articulating laparoscopic instruments: A prospective multicenter study

“…Recently, there have been reports on the use of ArtiSential instruments in general surgery, and the surgical outcomes appear to be favorable. [1][2][3] However, there are as yet no reports on the use of ArtiSential in the field of gynecologic surgery.…”

“…By enabling a wider range of motion and, thus, greater precision in procedures, ArtiSential has the potential to overcome the limitations associated with conventional laparoscopic surgery. Recently, there have been reports on the use of ArtiSential instruments in general surgery, and the surgical outcomes appear to be favorable 1–3 . However, there are as yet no reports on the use of ArtiSential in the field of gynecologic surgery.…”