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Envisioning the future of colorectal surgery: preclinical assessment and detailed description of an endoluminal robotic system (ColubrisMX ELS)

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Abstract

Background

The EndoLuminal Surgical System (ELS) is an emerging non-linear robotic system specifically designed for transanal surgery that allows for excision of colorectal neoplasia and luminal defect closure.

Methods

An evaluation of ELS was conducted by a single surgeon in a preclinical setting at the EndoSurgical Center of Florida in Orlando, between October 1st, 2020 and December 31st, 2020, using porcine colon as a model. Mock lesions measured 2.5 to 3.5 cm were excised partial-thickness. Specimen quality and excision time was assessed and evaluated.

Results

Twenty consecutive robotic transanal minimally invasive surgery (TAMIS) operations utilizing the ELS system were successfully performed without fragmentation. The mean and standard deviation procedure time for all 20 cases was 18.41 ± 14.15 min. The latter 10 cases were completed in substantially less time, suggesting that ELS requires at least 10 preclinical cases for a surgeon to become familiar with the technology. A second task, namely suture closure of the partial-thickness defect, was performed in 9 of the 20 cases. Mean time and standard deviation for this task measured 27.89 ± 10.07 min. There were no adverse events.

Conclusions

ELS was successful in performing the tasks of partial-thickness disc excision and closure in a preclinical evaluation. Further study is necessary to determine its clinical applicability.

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Authors and Affiliations

  1. UCF College of Medicine, Orlando, FL, USA

    S. Atallah, E. Bianchi & S. W. Larach

  2. AdventHealth, Orlando, FL, USA

    S. Atallah, A. Sanchez, E. Bianchi & S. W. Larach

Authors
  1. S. Atallah
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  2. A. Sanchez
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  3. E. Bianchi
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  4. S. W. Larach
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Corresponding author

Correspondence to S. Atallah.

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Conflict of interest

Dr. Sam Atallah is a constultant and clinical trial principle investigator for ColubrisMX. Dr. Alexis Sanchez is a research coordinator who received fees for activity related to ColubrisMX ELS investigational research. Dr. Sergio Larach and Dr. Elisa Bianchi have no financial relationships to disclose. The research conducted represents the authors’ own work.

Ethical Approval

This research was performed 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.

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Informed consent was not applicable as the work represented herein did not involve human subjects. Cadaveric research was conducted in accordance with the standards set forth by ethics and scientific laboratory regulations.

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Atallah, S., Sanchez, A., Bianchi, E. et al. Envisioning the future of colorectal surgery: preclinical assessment and detailed description of an endoluminal robotic system (ColubrisMX ELS). Tech Coloproctol 25, 1199–1207 (2021). https://doi.org/10.1007/s10151-021-02481-0

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