Spurzem Graham J, Jimenez Julio, Paravic Natasha, Robles Ignacio, Yañez Marcelo, Escalona Gabriel, Carmona Carolina, Mendez Isidora, Hidalgo Matias, Broderick Ryan C, Horgan Santiago
Department of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.
Department of Surgery and Anesthesiology, Hospital Luis Tisné, Santiago, Chile.
Surg Endosc. 2025 Jul;39(7):4463-4469. doi: 10.1007/s00464-025-11879-y. Epub 2025 Jun 11.
Magnetic-assisted robotic surgery (MARS) is a new platform developed to maximize the benefits of minimally invasive surgery for patients while enhancing surgeon control and visualization. The system is composed of two robotic arms that enable surgeon control of the laparoscopic camera and a deployable intraperitoneal magnetic grasper designed to provide incisionless retraction. The aim of this study was to evaluate the outcomes of the MARS platform following its use in outpatient laparoscopic cholecystectomy by a solo surgeon and examine patient perceptions of this approach.
A retrospective review of a prospectively maintained database identified all patients who underwent outpatient reduced port laparoscopic cholecystectomy assisted by MARS for symptomatic cholelithiasis from January 2024 to August 2024 at a tertiary care hospital. All cholecystectomies were performed without a surgical assistant. Primary outcomes were 30-day morbidity, 30-day readmission, operative time, and 30-day patient satisfaction as measured by a modified version of the Surgical Satisfaction Questionnaire (SSQ).
Fifty-one patients were identified. Mean age was 47.3 ± 13.9 years and most patients were female (N = 45, 88.2%). Mean operative time was 52.8 ± 16.3 min. All patients were discharged within 6 h after surgery. There were no 30-day morbidities or readmissions. Forty patients (78.4%) completed the modified SSQ at 30 days postoperatively and reported high degrees of satisfaction with pain management, return to preoperative baseline function, and the overall surgical experience. 92.5% of patients were "very satisfied" with the use of the MARS system and 97.5% would recommend use of the system to others.
This study demonstrates the safety and feasibility of the MARS platform for use in outpatient reduced port laparoscopic cholecystectomy by a solo surgeon with high patient satisfaction. MARS was particularly useful for simultaneous gallbladder retraction and laparoscopic camera manipulation by the operating surgeon, thus eliminating the need for a surgical assistant.
磁辅助机器人手术(MARS)是一个新开发的平台,旨在为患者最大限度地实现微创手术的益处,同时增强外科医生的控制能力和视野。该系统由两个机器人手臂组成,可让外科医生控制腹腔镜摄像头,还有一个可展开的腹腔内磁性抓持器,旨在实现无切口牵拉。本研究的目的是评估MARS平台在一名外科医生进行门诊腹腔镜胆囊切除术后的效果,并调查患者对这种手术方式的看法。
对一个前瞻性维护的数据库进行回顾性分析,确定了2024年1月至2024年8月在一家三级医院因有症状胆结石接受MARS辅助的门诊减少端口腹腔镜胆囊切除术的所有患者。所有胆囊切除术均在没有手术助手的情况下进行。主要结局指标包括30天发病率、30天再入院率(再次入院率)、手术时间,以及通过改良版手术满意度问卷(SSQ)测量的30天患者满意度。
共确定了51例患者。平均年龄为47.3±13.9岁,大多数患者为女性(N = 45,88.2%)。平均手术时间为52.8±16.3分钟。所有患者均在术后6小时内出院。无30天发病率或再入院情况。40例患者(78.4%)在术后30天完成了改良版SSQ,并报告对疼痛管理、恢复到术前基线功能以及整体手术体验高度满意。92.�%的患者对MARS系统的使用“非常满意”,97.5%的患者会向他人推荐使用该系统。
本研究证明了MARS平台用于一名外科医生进行门诊减少端口腹腔镜胆囊切除术的安全性和可行性,患者满意度高。MARS对于手术医生同时进行胆囊牵拉和腹腔镜摄像头操作特别有用,从而无需手术助手。