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Versius 用于机器人辅助胸外科手术的创新设备的临床前评估。

Preclinical evaluation of Versius, an innovative device for use in robot-assisted thoracic surgery.

机构信息

Cardiothoracic Surgical Department, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.

Department of Thoracic Surgery, James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.

出版信息

Eur J Cardiothorac Surg. 2022 Aug 3;62(3). doi: 10.1093/ejcts/ezac178.

Abstract

OBJECTIVES

The adoption of robot-assisted thoracic surgery (RATS) has helped to overcome some of the challenges associated with surgeons performing conventional video-assisted thoracic surgery. The Versius Surgical System (CMR Surgical, Cambridge, UK) has been developed iteratively in line with surgical team feedback to improve the surgeon's experience and patient outcomes. The goal of this study was to assess the use of the device in RATS in a preclinical setting and to fulfil Idea, Development, Exploration, Assessment, Long-Term Follow Up-Devices stage 1 (Idea).

METHODS

Four cadaveric sessions were conducted between November 2018 and December 2020, during which device performance in a range of thoracic operations was assessed. Procedures were categorized as either completed or not completed, and surgeons evaluated the device's ability to successfully complete necessary surgical steps. Port and bedside unit positions were recorded.

RESULTS

In total, 22/24 (91.7%) thoracic procedures were successfully completed, including 17/18 lobectomies, 2/3 thymectomies and 3/3 diaphragm plications, in 9 cadaver specimens. One thymectomy could not be completed due to cadaver anatomy and 1 lobectomy was not completed due a console system fault. Port and bedside unit configurations were successfully validated for all procedures, and lead surgeons deemed the device to be well-suited for thoracic surgery.

CONCLUSIONS

This preclinical study demonstrated the successful use of the device in RATS in cadaveric models and supports progression to small-scale clinical studies, as part of Idea, Development, Exploration, Assessment, Long-Term Follow Up-Devices stage 2a (Development).

摘要

目的

机器人辅助胸腔手术(RATS)的采用有助于克服外科医生进行传统电视辅助胸腔手术时所面临的一些挑战。Versius 手术系统(CMR Surgical,英国剑桥)根据手术团队的反馈进行了迭代开发,以改善外科医生的体验和患者的治疗效果。本研究的目的是评估该设备在临床前 RATS 中的应用,并完成 Idea、Development、Exploration、Assessment、Long-Term Follow Up-Devices 阶段 1(Idea)。

方法

在 2018 年 11 月至 2020 年 12 月期间进行了 4 次尸体手术,在此期间评估了该设备在一系列胸腔手术中的性能。将手术分为完成和未完成两类,并评估了外科医生成功完成必要手术步骤的能力。记录了端口和床边单元的位置。

结果

总共完成了 22/24(91.7%)例胸部手术,包括 18 例肺叶切除术、3 例膈肌折叠术中的 2 例和 3 例胸腺切除术。由于尸体解剖结构的原因,1 例胸腺切除术无法完成,由于控制台系统故障,1 例肺叶切除术未完成。所有手术的端口和床边单元配置均成功验证,主刀医生认为该设备非常适合胸腔手术。

结论

本临床前研究证明了该设备在尸体模型中 RATS 的成功应用,并支持将其推进到小型临床研究,作为 Idea、Development、Exploration、Assessment、Long-Term Follow Up-Devices 阶段 2a(Development)的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcac/9422751/456fdbf8cf58/ezac178f5.jpg

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