Kim Seijong, Lee Jaeim, Oh Heung-Kwon, Pyo Dae Hee, Lee Yoon Suk, Yoon Yong Sik, Bae Dong Hwan, Min Byung Soh, Kim Chang Hyun, Huh Jung Wook
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea.
Department of Surgery, Uijeongbu St. Mary'S Hospital, the Catholic University of Korea, Uijeongbu-Si, Korea.
Surg Endosc. 2025 May;39(5):2931-2937. doi: 10.1007/s00464-025-11670-z. Epub 2025 Mar 20.
Minimally invasive surgery for colorectal cancer has demonstrated significant advantages over traditional methods, but laparoscopic procedures remain technically challenging. ArtiSential is an articulated handheld laparoscopic system designed to offer greater maneuverability similar to robotic surgery, while addressing cost constraints. However, its clinical efficacy in right hemicolectomy (RHC) for right-sided colon cancer remains underexplored.
A multicenter, retrospective study was conducted from January 2021 to October 2022, enrolling 511 patients who underwent laparoscopic RHC for right-sided colon cancer. Of these, 167 patients underwent ArtiSential-assisted RHC, while 344 underwent conventional RHC. Propensity-score matching (PSM) was used to balance baseline variables. Additionally, we employed cumulative sum analysis to evaluate the learning curve associated with ArtiSential use.
After PSM, each group consisted of 165 patients, with no significant differences in baseline clinical characteristics. The median operation time was 148 min for both procedures (p = 0.423). No significant differences were observed in complication rates, including intraoperative blood loss, open conversion, postoperative ileus, anastomotic leakage, or wound complications between ArtiSential-assisted RHC and conventional RHC. Moreover, the total expenses were not different between the groups. Cumulative sum analysis indicated that surgeons reached proficiency with ArtiSential after an average of 19 cases.
ArtiSential-assisted RHC proves to be a safe and feasible option, yielding comparable outcomes to conventional RHC with no significant differences in intraoperative or postoperative metrics. Surgeons can achieve proficiency with ArtiSential after performing an average of 19 cases. These findings suggest that ArtiSential could be a valuable addition to the minimally invasive surgical toolkit for right-sided colon cancer treatment.
结直肠癌的微创手术已显示出相对于传统方法的显著优势，但腹腔镜手术在技术上仍具有挑战性。ArtiSential是一种关节式手持式腹腔镜系统，旨在提供类似于机器人手术的更大可操作性，同时解决成本限制问题。然而，其在右侧结肠癌右半结肠切除术（RHC）中的临床疗效仍未得到充分研究。
2021年1月至2022年10月进行了一项多中心回顾性研究，纳入511例行腹腔镜右侧结肠癌RHC的患者。其中，167例患者接受了ArtiSential辅助RHC，344例接受了传统RHC。采用倾向评分匹配（PSM）来平衡基线变量。此外，我们采用累积和分析来评估与使用ArtiSential相关的学习曲线。
PSM后，每组各有165例患者，基线临床特征无显著差异。两种手术的中位手术时间均为148分钟（p = 0.423）。ArtiSential辅助RHC与传统RHC在并发症发生率方面无显著差异，包括术中失血、中转开腹、术后肠梗阻、吻合口漏或伤口并发症。此外，两组之间的总费用无差异。累积和分析表明，外科医生平均在完成19例手术后对ArtiSential达到熟练程度。
ArtiSential辅助RHC被证明是一种安全可行的选择，其结果与传统RHC相当，术中或术后指标无显著差异。外科医生平均在完成19例手术后可熟练使用ArtiSential。这些发现表明，ArtiSential可能是右侧结肠癌治疗微创外科工具包中的一个有价值的补充。
