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Single-port robotic left colectomy: first clinical experience using the SP robot (rSILS)

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Abstract

Background

The single-port daVinci robot is a new platform designed to facilitate single-incision surgeries. The objective of this study was to describe the first clinical experience in colorectal surgery using a novel single-port robotic system and report its feasibility and safety.

Methods

After Institutional Review Board approval was obtained and the study was registered with ClinicalTrials.gov, we performed single port robot-assisted left colectomy using the novel daVinci SP surgical system on two patients. The surgeries were completed through a single incision. The multichannel port accommodates a three-dimensional articulating camera and three double-jointed articulating instruments. The primary aim of this study was to report, for the first time in the USA, the technical feasibility of the procedure in the living human. The secondary aim was to report the outcomes including blood loss, number of incisions, number of dockings, docking time of the robot, incision length, operative time, console time, need for additional port and instrumentation, intraoperative complications, morbidity and mortality, time for tolerating diet, bowel function, and discharge.

Results

Both surgeries were completed without conversion through a single incision, 4.0 and 4.5 cm in size. Estimated blood loss was less than 60 ml in both cases. The robot was docked two and three times. Mean time to dock was 13 min (range 3–33 min). There were no intraoperative complications, no morbidity or death. Discharges occurred on postoperative days 2 and 3.

Conclusions

Single-port robotic colectomy using the new robot is feasible and can be safely completed. The overall utility and functionality of the SP robot portends wide utilization and expansion of this technique. Careful development and analysis of the procedure outcomes, training, and cost will be necessary to properly advance the field.

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Funding

There are no funding sources to report.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Lankenau Medical Center, Wynnewood, PA, USA

    J. H. Marks, J. F. Salem, B. K. Anderson, J. M. Josse & H. P. Schoonyoung

  2. The Colorectal Center at Lankenau Medical Center, Medical Science Building, Suite 375, 100 East Lancaster Avenue, Wynnewood, PA, 19096, USA

    J. H. Marks

Authors
  1. J. H. Marks
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  2. J. F. Salem
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  3. B. K. Anderson
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  4. J. M. Josse
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  5. H. P. Schoonyoung
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Corresponding author

Correspondence to J. H. Marks.

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Conflict of interest

Dr. John Marks has been engaged with Intuitive Surgical in a consultative fashion to help develop the safe application of the SP robot. This has entailed detailed conversation as well as cadaver work utilizing a protocol robot. Over this period, he has been compensated $5000.00. The other authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Marks, J.H., Salem, J.F., Anderson, B.K. et al. Single-port robotic left colectomy: first clinical experience using the SP robot (rSILS). Tech Coloproctol 24, 57–63 (2020). https://doi.org/10.1007/s10151-019-02129-0

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  • DOI: https://doi.org/10.1007/s10151-019-02129-0

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