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Comparative early results of a robotics-assisted endoscope holder in single port thoracoscopic surgery in the era of COVID-19.
Wu, Ching Feng; Wu, Ching Yang; Chao, Yin Kai; Gonzalez-Rivas, Diego; Hsieh, Ming Ju; Pan, Yu Bin; Yang, Lan Yan.
  • Wu CF; Chang Gung University, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.
  • Wu CY; Coruña University Hospital; Minimally Invasive Thoracic Surgery Unit (UCTMI), Department of Thoracic Surgery, CORUÑA, Spain.
  • Chao YK; Chang Gung University, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.
  • Gonzalez-Rivas D; Chang Gung University, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.
  • Hsieh MJ; Coruña University Hospital; Minimally Invasive Thoracic Surgery Unit (UCTMI), Department of Thoracic Surgery, CORUÑA, Spain.
  • Pan YB; Chang Gung University, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. hsiehmj2@gmail.com.
  • Yang LY; Biostatistics Unit, Clinical Trial Center, Chang Gung Memorial Hospital, Taoyüan, Taiwan.
Surg Endosc ; 36(7): 5501-5509, 2022 07.
Article in English | MEDLINE | ID: covidwho-1669809
ABSTRACT

BACKGROUND:

Innovations in surgical instruments have made single-port surgery more widely accepted and lead to a reduced demand for surgical assistants. As COVID-19 has ravaged the world, maintaining minimum medical staffing requirements and proper social distancing have become major topics of interest. We sought to evaluate the feasibility of applying the unisurgeon approach in single-port video-assisted thoracoscopic surgery aided by a robotic camera holder.

METHODS:

Operative time, blood loss, setup time, postoperative hospital stays, and the number of participating surgeons in single-port video-assisted thoracoscopic lung resections were gathered for investigation after the introduction of the ENDOFIXexo robotic endoscope holder system. In this cohort, we collected 213 patients who underwent single port video thoracoscope surgery, including 57 patients underwent robotic endoscope arm assisted surgery and case-matched 52 patients in the robotic arm-assisted group with patients in the human-assisted group through propensity score-matched analysis.

RESULTS:

In wedge resection, a single surgeon was able to completely operate on all lobes of target lesions. However, for anatomical resections, namely segmentectomy, the success rate was 95%, and for lobectomy, the success rate was only 64%. No significant differences between setup times, blood loss, or operative times between the two groups were observed.

CONCLUSIONS:

When an experienced uniport surgeon is assisted by a robotic endoscope holder, wedge resection is the most suitable procedure to be performed through unisurgeon single-port video-assisted thoracoscopic surgery without increasing setup time, operative time, or short-term complications. Verification of the technique's applicability for use in anatomic resections requires further investigation.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Lung Neoplasms Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Surg Endosc Journal subject: Diagnostic Imaging / Gastroenterology Year: 2022 Document Type: Article Affiliation country: S00464-022-09054-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Lung Neoplasms Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Surg Endosc Journal subject: Diagnostic Imaging / Gastroenterology Year: 2022 Document Type: Article Affiliation country: S00464-022-09054-8