Min Sa-Hong, Cho Yo-Seok, Park Kibum, Lee Yoontaek, Park Young Suk, Ahn Sang-Hoon, Park Do Joong, Kim Hyung-Ho
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
J Minim Invasive Surg. 2019 Dec 15;22(4):157-163. doi: 10.7602/jmis.2019.22.4.157.
Although laparoscopic surgery had been performed in clinical practice for over 30 years, there has not been much improvement on instruments. Several articulating laparoscopic instruments have been developed including the robotic system. A new multi-degree of freedom (DOF) articulating laparoscopic device has been developed. We compared the ability to perform challenging sutures between the new device and the robotic system.
Five experienced surgeons with over 100 laparoscopic surgery cases performed the suture task with both instruments. Everyone was new at articulating instruments including a robotic system. The suturing task consisted of two vertical sutures, downward and upward vertical direction. The duration of needle grabbing, first surgical tie, square tie, and the final reverse tie was measured.
When doing the downward suture, the median time to complete the suture was 127 vs. 136 seconds for ArtiSential and the robot, respectively (=0.754). Other measurements such as needle grabbing, first tie, second tie and final knot did not show any significant difference between the two instruments. Upward suture also did not show a significant difference. The total completion time was 127 vs. 112 seconds for for ArtiSential and the robot, respectively (=0.675). Time taken in each interval did not show any significant difference.
Both instruments performed the suturing tasks with no difference in duration. ArtiSential can be mixed up with usual instruments. Surgeons can choose any device, but when articulation is needed, ArtiSential could be an alternative choice to the robotic system.
尽管腹腔镜手术已在临床实践中开展了30多年，但手术器械却没有太大改进。包括机器人系统在内，已开发出多种可弯曲腹腔镜器械。一种新型多自由度可弯曲腹腔镜设备已研制成功。我们比较了这种新设备与机器人系统在进行具有挑战性缝合操作方面的能力。
五名有超过100例腹腔镜手术经验的外科医生使用这两种器械完成缝合任务。每个人对包括机器人系统在内的可弯曲器械都是新手。缝合任务包括两条垂直缝合线，分别为向下和向上的垂直方向。测量了夹针时间、第一次手术打结、方结和最终反向打结的时间。
进行向下缝合时，ArtiSential和机器人完成缝合的中位时间分别为127秒和136秒（P=0.754）其他测量指标，如夹针、第一次打结、第二次打结和最终打结，在两种器械之间均未显示出显著差异。向上缝合也未显示出显著差异。ArtiSential和机器人的总完成时间分别为127秒和112秒（P=0.67）。每个时间段所花费的时间均未显示出显著差异。
两种器械在完成缝合任务时，时间上没有差异。ArtiSential可以与常规器械混用。外科医生可以选择任何一种设备，但在需要可弯曲功能时，ArtiSential可能是机器人系统的替代选择。
