Abstract
Background
Intragastric surgery is accepted as a minimally invasive procedure for mucosal or submucosal lesions. Robotic surgery promises to extend the capabilities of the minimally invasive surgeon and many surgical specialties are applying this new technology. However, there is no report of robotic intragastric surgery. We describe the use of the da Vinci® Surgical System for intraluminal mucosal resection of the stomach.
Methods
We developed our porcine intragastric surgery model using the Tuebingen MIS Trainer. We set a tentative lesion on the posterior wall near the esophagocardiac junction (ECJ) of the stomach and performed mucosal resection of the lesion using the da Vinci Surgical System. We also performed closure of the defect after mucosal resection and subsequent closure of the intentional gastric perforation.
Results
Using our porcine intragastric surgery model, we successfully performed mucosal resection of the tentative lesion. We also smoothly completed closure of the defect and closure of the perforation without any complications. The mean size of the mucosa was 6 cm and the mean duration of the procedure was only 12 min.
Conclusions
The safety and efficacy of robotic intragastric surgery was preliminarily established in this study. However, further studies are needed to prove its practical feasibility in humans using the da Vinci Surgical System to make it an effective operation.
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References
Cadiere GB, Himpens J, Vertruyen M, Bruyns J, Fourtanier G (1999) Nissen fundoplication done by remotely controlled robotic technique. Ann Chir 53: 137–141
Falk V, Gummert JF, Walther T, Hayase M, Berry GJ, Mohr FW (1999). Quality of computer enhanced totally endoscopic coronary bypass graft anastomosis - comparison to conventional technique. Eur J Cardiothorac Surg 15: 260–264; discussion 264–265
Giulianotti PC, Coratti A, Angelini M, Sbrana F, Cecconi S, Balestracci T, Caravaglios G (2003) Robotics in general surgery: personal experience in a large community hospital. Arch Surg 138: 777–784
Guillonneau B, Jayet C, Tewari A, Vallancien G (2001) Robot-assisted laparoscopic nephrectomy. Urology 166: 200–201
Kitagawa Y, Kitano S, Kubota T, Kumai K, Otani Y, Saikawa Y, Yoshida M, Kitajima M (2005) Minimally invasive surgery for gastric cancer - toward a confluence of two major streams: a review. Gastric Cancer 8: 103–110
Marescaux J, Leroy J, Gagner M, Rubino F, Mutter D, Vix M, Butner SE, Smith MK (2001) Transatlantic robot-assisted telesurgery. Nature 27(413): 379–380
Marescaux J, Smith MK, Folscher D, Jamali F, Malassagne B, Leroy J (2001) Telerobotic laparoscopic cholecystectomy: initial clinical experience with 25 patients. Ann Surg 234: 1–7
Melfi FM, Menconi GF, Mariani AM, Angeletti CA (2002) Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg 21: 864–868
Ohashi S (1995) Laparoscopic intraluminal (intragastric) surgery for early gastric cancer. A new concept in laparoscopic surgery. Surg Endosc 9: 169–171
Ono H, Kondo H, Gotoda T, Shirao K, Yamaguchi H, Saito D, Hosokawa K, Shimoda T, Yoshida S (2001) Endoscopic mucosal resection for treatment of early gastric cancer. Gut 48: 225–229
Rembacken BJ, Gotoda T, Fujii T, Axon AT (2001) Endoscopic mucosal resection. Endoscopy 33: 709–718
Sekimoto M, Tamura S, Hasuike Y, Yano M, Murata A, Inoue M, Shiozaki H, Monden M (1999) A new technique for laparoscopic resection of a submucosal tumor on the posterior wall of the gastric fundus. Surg Endosc 13: 71–74
Waseda M, Inaki N, Mailaender L, Buess GF (2005) An innovative trainer for surgical procedures using animal organs. Minim Invasive Ther Allied Technol 14: 262–266
Acknowledgment
This research was partially supported by the Ministry of Education, Science, Sports, Culture and Technology Grant-in-Aid for Young Scientists (B), 18790957, 2006.
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Hirano, Y., Ishikawa, N., Omura, K. et al. Robotic intragastric surgery: A new surgical approach for the gastric lesion. Surg Endosc 21, 2112–2114 (2007). https://doi.org/10.1007/s00464-007-9271-3
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DOI: https://doi.org/10.1007/s00464-007-9271-3