Robot-assisted minimally invasive Kasai portoenterostomy: a survival porcine study

• Published in: Surgical endoscopy Vol. 18; no. 7; pp. 1136 - 1139
• Main Authors: LORINCZ, A, KNIGHT, C. G, LANGENBURG, S. E, RABAH, R, GIDELL, K, DAWE, E, GRANT, S, KLEIN, M. D
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01-07-2004; Springer Nature B.V
• Subjects: Animals; Animals, Newborn; Biological and medical sciences; Equipment Design; General aspects; Intestinal Obstruction - etiology; Learning; Medical sciences; Minimally Invasive Surgical Procedures; Peritonitis - etiology; Portoenterostomy, Hepatic - instrumentation; Portoenterostomy, Hepatic - methods; Postoperative Complications - etiology; Robotics; Sus scrofa; Wound Healing; Medicine; Kasai portoenterostomy; Vertebrata; Mammalia; Minimally invasive robotic surgery; Robot-assisted portoenterostomy - Zeus Microwrist System; Artiodactyla; Survival; Ungulata; Pig
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-003-8259-x

Major enhancements offered by robotic surgery for minimally invasive procedure include tremor filtration, motion scaling, and the addition of a wrist to the instrument. Minor enhancements include indexing as well as safe and rapid instrument exchange. A benefit associated with any endoscopic procedure is magnification. It was hypothesized that these enhancements would allow the performance of complex gastrointestinal surgery.
Eight survival pigs (weight, 2.5-8 kg) underwent a robotically assisted minimally invasive portoenterostomy. The procedure was analogous to the Kasai portoenterostomy for biliary atresia usually performed for human patients at the age of 4 to 12 weeks.
Five of the eight animals survived for more than 1 month after the operation, returning to normal eating and bowel habits in 2 to 3 days. None were jaundiced. All laboratory values were normal. At 1 month, the animals were killed. There was no anastomotic stenosis at either the end-to-side enteroenterostomy or the portoenterostomy. Histologically, the anastomoses were well healed.
Computer-assisted robot-enhanced technology allows complex gastrointestinal surgery to be performed using minimally invasive techniques.