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Single-surgeon surgery in laparoscopic colonie resection.

Hildebrandt, U. M.D.; Plusczyk, T. M.D.; Kessler, K. M.D.; Menger, M. D. M.D.
Diseases of the Colon & Rectum: December 2003
doi: 10.1007/BF02660769
Original Contribution: PDF Only

PURPOSE: Short-term benefits have been demonstrated for laparoscopic-assisted colectomy. However, minimally invasive surgery is still in an evolutionary phase. In demonstrating that robotic devices also are useful in laparoscopic colonie surgery, it is fundamental to prove that a single surgeon can perform almost the entire operation on his own.

METHODS: A single surgeon performed forty-one, laparoscopic-assisted, colorectal resections with the assistance of a robotic device (Automated Endoscopie System for Optimal Positioning, Computer MotionTM) maneuvering the laparoscope. A surgical assistant was included only for the open part of the operation. Main outcome measures were conversion rate, total operating time, and percentage of assistance by a second surgeon.

RESULTS: There were no intraoperative complications, one case of conversion to open surgery, and three postoperative complications. The total operating time ranged from 126 to 252 minutes. A single surgeon with the assistance of a robotic device was able to perform approximately 70 percent of an ileocecal resection, 70 percent of a right hemicolectomy, 80 percent of a sigmoid resection, and 85 percent of a anterior rectal resection without further help of a surgeon.

CONCLUSIONS: A single surgeon with the assistance of a computerized robotic system can complete at least two-thirds of a laparoscopic-assisted, colorectal resection on his own. The use of a robotic device in laparoscopic-assisted, colonie surgery is safe, efficient, and feasible, and will proven even more so in future. This also will result in a patient-driven demand for high-standard, minimally invasive surgery.

(C) The ASCRS 2003