Robotic endoscopic surgery in a porcine model of the infant neck
Identifieur interne : 004798 ( Ncbi/Checkpoint ); précédent : 004797; suivant : 004799Robotic endoscopic surgery in a porcine model of the infant neck
Auteurs : Russell A. Faust [États-Unis] ; Adrien J. Kant [États-Unis] ; Attila Lorincz [États-Unis] ; Abbas Younes [États-Unis] ; Elizabeth Dawe [États-Unis] ; Michael D. Klein [États-Unis]Source :
- Journal of Robotic Surgery [ 1863-2483 ] ; 2007.
Abstract
Minimally invasive surgery is rapidly becoming the desired surgical standard, especially for pediatric patients. Infants and children are a particular technical challenge, however, because of the small size of target anatomical structures and the small surgical workspace. Computer-assisted robot-enhanced surgical telemanipulators may overcome these challenges by facilitating surgery in a small workspace. We studied the feasibility of performing robotic endoscopic neck surgery on a porcine model of the human infant neck. The study design was a prospective, feasibility pilot study of a small cohort for proof of concept and for a survival model. Sixteen non-survival piglets weighing 4.5–10 kg were used to develop the surgical approach and operative technique. Eight piglets aged 3–6 weeks old and weighing 4.0–9.1 kg underwent survival thyroidectomy by a cervical endoscopic approach using the Zeus surgical robot, which includes the Aesop endoscope holder and “Microwrist” microdissecting instruments. We succeeded in performing endoscopic robotic neck surgery on a piglet as small as 4 kg, in an operative pocket as small as 2 cm3. Total incision length for all three ports was ≤23 mm. There were no major complications, no major robotic instrument malfunctions or breakages, and no procedures required conversion to open surgery. These results support the feasibility of robotic endoscopic neck surgery on a neck the size of a human infant’s.
The online version of this article (doi: 10.1007/s11701-006-0007-5) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1007/s11701-006-0007-5
PubMed: NONE
PubMed Central: 4677346
Affiliations:
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neck</title><author><name sortKey="Faust, Russell A" sort="Faust, Russell A" uniqKey="Faust R" first="Russell A." last="Faust">Russell A. Faust</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit, MI 48201 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit</wicri:cityArea></affiliation></author><author><name sortKey="Kant, Adrien J" sort="Kant, Adrien J" uniqKey="Kant A" first="Adrien J." last="Kant">Adrien J. Kant</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit, MI 48201 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit</wicri:cityArea></affiliation></author><author><name sortKey="Lorincz, Attila" sort="Lorincz, Attila" uniqKey="Lorincz A" first="Attila" last="Lorincz">Attila Lorincz</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit, MI 48201 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit</wicri:cityArea></affiliation></author><author><name sortKey="Younes, Abbas" sort="Younes, Abbas" uniqKey="Younes A" first="Abbas" last="Younes">Abbas Younes</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit, MI 48201 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit</wicri:cityArea></affiliation></author><author><name sortKey="Dawe, Elizabeth" sort="Dawe, Elizabeth" uniqKey="Dawe E" first="Elizabeth" last="Dawe">Elizabeth Dawe</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit, MI 48201 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit</wicri:cityArea></affiliation></author><author><name sortKey="Klein, Michael D" sort="Klein, Michael D" uniqKey="Klein M" first="Michael D." last="Klein">Michael D. Klein</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit, MI 48201 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit</wicri:cityArea></affiliation></author></analytic><series><title level="j">Journal of Robotic Surgery</title><idno type="ISSN">1863-2483</idno><idno type="eISSN">1863-2491</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Minimally invasive surgery is rapidly becoming the desired surgical standard,
especially for pediatric patients. Infants and children are a particular technical
challenge, however, because of the small size of target anatomical structures and
the small surgical workspace. Computer-assisted robot-enhanced surgical
telemanipulators may overcome these challenges by facilitating surgery in a small
workspace. We studied the feasibility of performing robotic endoscopic neck surgery
on a porcine model of the human infant neck. The study design was a prospective,
feasibility pilot study of a small cohort for proof of concept and for a survival
model. Sixteen non-survival piglets weighing 4.5–10 kg were used to develop the
surgical approach and operative technique. Eight piglets aged 3–6 weeks old and
weighing 4.0–9.1 kg underwent survival thyroidectomy by a cervical endoscopic
approach using the Zeus surgical robot, which includes the Aesop endoscope holder
and “Microwrist” microdissecting instruments. We succeeded in performing endoscopic
robotic neck surgery on a piglet as small as 4 kg, in an operative pocket as small
as 2 cm<sup>3</sup>. Total incision length for all three ports was
≤23 mm. There were no major complications, no major robotic instrument malfunctions
or breakages, and no procedures required conversion to open surgery. These results
support the feasibility of robotic endoscopic neck surgery on a neck the size of a
human infant’s.</p><sec><title>Electronic supplementary material</title><p>The online version of this article (doi: 10.1007/s11701-006-0007-5) contains supplementary material, which is available to authorized
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Niimi</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Haus, Gm" uniqKey="Haus G">GM Haus</name></author><author><name sortKey="Kambham, N" uniqKey="Kambham N">N Kambham</name></author><author><name sortKey="Le, D" uniqKey="Le D">D Le</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hockstein, Ng" uniqKey="Hockstein N">NG Hockstein</name></author><author><name sortKey="Nolan, Pj" uniqKey="Nolan P">PJ Nolan</name></author><author><name sortKey="O Alley, Bw" uniqKey="O Alley B">BW O’Malley</name></author><author><name sortKey="Woo, Yj" uniqKey="Woo Y">YJ Woo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="O Alley, Bw" uniqKey="O Alley B">BW O’Malley</name></author><author><name sortKey="Weinstein, Gs" uniqKey="Weinstein G">GS Weinstein</name></author><author><name sortKey="Snyder, W" uniqKey="Snyder W">W Snyder</name></author><author><name sortKey="Hockstein, Ng" uniqKey="Hockstein N">NG Hockstein</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Michigan</li></region></list><tree><country name="États-Unis"><region name="Michigan"><name sortKey="Faust, Russell A" sort="Faust, Russell A" uniqKey="Faust R" first="Russell A." last="Faust">Russell A. Faust</name></region><name sortKey="Dawe, Elizabeth" sort="Dawe, Elizabeth" uniqKey="Dawe E" first="Elizabeth" last="Dawe">Elizabeth Dawe</name><name sortKey="Kant, Adrien J" sort="Kant, Adrien J" uniqKey="Kant A" first="Adrien J." last="Kant">Adrien J. Kant</name><name sortKey="Klein, Michael D" sort="Klein, Michael D" uniqKey="Klein M" first="Michael D." last="Klein">Michael D. Klein</name><name sortKey="Lorincz, Attila" sort="Lorincz, Attila" uniqKey="Lorincz A" first="Attila" last="Lorincz">Attila Lorincz</name><name sortKey="Younes, Abbas" sort="Younes, Abbas" uniqKey="Younes A" first="Abbas" last="Younes">Abbas Younes</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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