Robotic DIEP Flap Harvest through a Totally Extraperitoneal Approach Using a Single-Port Surgical Robotic System

Abstract Background A congenital prepubic sinus (CPS) is a rare congenital anomaly in which a duct remnant extends from the skin opening near the pubic symphysis to various parts and the lesions are mostly located in the preperitoneal space. The totally extraperitoneal (TEP) approach is an operational method that provides a good field of view for the preperitoneal space. We report the CPS through the pubic symphysis in which complete resection was achieved by a TEP approach. TEP approach was minimally invasive and achieved satisfactory cosmetic outcome. Case presentation We herein report the case of a 13-year-old boy with a fistula opening near the dorsal penis. He was admitted to our hospital due to fever and lower abdominal pain. Abdominal ultrasonography and computed tomography revealed an abscess inside a fistula lumen on the posterior surface of the rectus abdominis muscles in the midline of the lower abdomen. Under a diagnosis of CPS, which was located in the preperitoneal space, endoscopic resection was performed by a totally extraperitoneal approach. After making an umbilical incision, the rectus abdominis muscle was excised outward to expose the preperitoneal space. A single-port system was placed in the preperitoneal space. Three 5-mm-port trocars were inserted. As the preperitoneal cavity was expanded, a sinus connecting to the pubic symphysis was confirmed. The pubic symphysis did not connect with the bladder. Because the fistula was penetrated with the pubic symphysis, the remaining caudal fistula was removed from the body surface with a small spindle-shaped incision around the fistula opening. Finally, the sinus was completely resected, with confirmation from both the cranial side and dorsal side of the pubic symphysis. We were able to perform complete resection of the CPS with good visibility and without any peritoneal damage. There were no intraoperative complications. His postoperative course was uneventful during the 1-year follow-up. Conclusions The TEP approach may be feasible for the resection of a CPS and may allow safe and secure resection due to good visibility, even in pediatric patients.

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Development of master-slave magnetic anchoring vision robotic system for single-port laparoscopy (SPL) surgery

Industrial Robot the international journal of robotics research and application ◽

10.1108/ir-01-2018-0016 ◽

2018 ◽

Vol 45 (4) ◽

pp. 458-468

Author(s):

Haibo Feng ◽

Yanwu Zhai ◽

Yili Fu

Keyword(s):

Single Port ◽

Robotic System ◽

Surgical Robot ◽

Distribution Analysis ◽

Robot System ◽

Content Type ◽

Blind Area ◽

Robot Systems ◽

Single Port Laparoscopy ◽

And Performance

Purpose Surgical robot systems have been used in single-port laparoscopy (SPL) surgery to improve patient outcomes. This study aims to develop a vision robot system for SPL surgery to effectively improve the visualization of surgical robot systems for relatively complex surgical procedures. Design/methodology/approach In this paper, a new master-slave magnetic anchoring vision robotic system for SPL surgery was proposed. A lighting distribution analysis for the imaging unit of the vision robot was carried out to guarantee illumination uniformity in the workspace during SPL surgery. Moreover, cleaning force for the lens of the camera was measured to assess safety for an abdominal wall, and performance assessment of the system was performed. Findings Extensive experimental results for illumination, control, cleaning force and functionality test have indicated that the proposed system has an excellent performance in providing the visual feedback. Originality/value The main contribution of this paper lies in the development of a magnetic anchoring vision robot system that successfully improves the ability of cleaning the lens and avoiding the blind area in a field of view.

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Totally extraperitoneal approach

Laparoscopic Hernia Surgery ◽

10.1201/b13406-17 ◽

2002 ◽

pp. 83-92

Keyword(s):

Extraperitoneal Approach ◽

Totally Extraperitoneal

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A Novel Robotic System for Single-port Urologic Surgery: First Clinical Investigation

European Urology ◽

10.1016/j.eururo.2014.06.039 ◽

2014 ◽

Vol 66 (6) ◽

pp. 1033-1043 ◽

Cited By ~ 121

Author(s):

Jihad H. Kaouk ◽

Georges-Pascal Haber ◽

Riccardo Autorino ◽

Sebastien Crouzet ◽

Adil Ouzzane ◽

...

Keyword(s):

Single Port ◽

Clinical Investigation ◽

Robotic System ◽

Urologic Surgery ◽

Surgery First

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Fibrin glue versus staple mesh fixation in single-port laparoscopic totally extraperitoneal inguinal hernia repair: A propensity score-matched analysis

International Journal of Surgery ◽

10.1016/j.ijsu.2018.01.029 ◽

2018 ◽

Vol 53 ◽

pp. 32-37 ◽

Cited By ~ 1

Author(s):

Byung Jo Choi ◽

Won Jun Jeong ◽

Sang Chul Lee

Keyword(s):

Inguinal Hernia ◽

Propensity Score ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Fibrin Glue ◽

Single Port ◽

Mesh Fixation ◽

Totally Extraperitoneal

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Ovarian cystectomy for a dermoid cyst with the new single-port robotic system

Minimally Invasive Therapy & Allied Technologies ◽

10.3109/13645706.2014.955029 ◽

2014 ◽

Vol 24 (2) ◽

pp. 123-126 ◽

Cited By ~ 3

Author(s):

Mete Gungor ◽

Korhan Kahraman ◽

Esra Ozbasli ◽

Canan Genim

Keyword(s):

Dermoid Cyst ◽

Single Port ◽

Robotic System ◽

Ovarian Cystectomy

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Transumbilical, Single-Port, Totally Extraperitoneal, Laparoscopic Inguinal Hernia Repair Using a Homemade Port and a Conventional Instrument: An Initial Experience

Journal of Laparoendoscopic & Advanced Surgical Techniques ◽

10.1089/lap.2011.0235 ◽

2012 ◽

Vol 22 (2) ◽

pp. 162-164 ◽

Cited By ~ 3

Author(s):

Tune-Yie Shih ◽

Kuo-Chang Wen ◽

Kai-Yuan Lin ◽

Yih-Huei Uen

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Single Port ◽

Laparoscopic Inguinal Hernia Repair ◽

Initial Experience ◽

Totally Extraperitoneal ◽

Laparoscopic Inguinal Hernia ◽

Conventional Instrument

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Single-Port Laparoscopy and Extraperitoneal Para-Aortic Lymphadenectomy: 3 Consecutive Cases

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e31822a0175 ◽

2011 ◽

Vol 21 (9) ◽

pp. 1695-1697 ◽

Cited By ~ 4

Author(s):

Sébastien Gouy ◽

Catherine Uzan ◽

Aminata Kane ◽

Tristan Gauthier ◽

Philippe Morice

Keyword(s):

Cervical Cancer ◽

Single Port ◽

Locally Advanced ◽

Laparoscopic Approach ◽

Squamous Carcinoma ◽

Extraperitoneal Approach ◽

Conventional Instruments ◽

Positron Emission ◽

Single Port Laparoscopy ◽

The Mean

ObjectiveWe report the feasibility and the technique of single-port extraperitoneal para-aortic lymphadenectomy in locally advanced cervical cancer.MethodsThe same single port was used for the transperitoneal step (to discriminate intraperitoneal disease) and the extraperitoneal approach used thereafter (in the absence of peritoneal or ovarian spread) for the lymphadenectomy. Para-aortic lymphadenectomy was performed via the left-sided extraperitoneal approach by a 2- to 3-cm incision, which was made 1 cm above the usual incision to the left of McBurney’s point. We used conventional instruments in all cases.ResultsThree consecutive patients with cervical cancer had undergone a pretherapeutic laparoscopic staging procedure (1 stage IB2 and 2 stage IIB). The histologic types were squamous carcinoma (n = 2) and adenocarcinoma (n = 1). No patients had pelvic or para-aortic uptakes on preoperative positron emission tomography computed tomography imaging. The mean operative time was 223 minutes (range, 210–250 minutes). The mean number of lymph nodes removed was 19 (range, 15–23). The definitive pathological analysis had revealed that one patient had metastatic disease. No failures occurred with the single-port procedure, and no conversion to conventional multiport laparoscopy was reported.ConclusionsThis preliminary series reports on the feasibility of the para-aortic lymphadenectomy technique via the extraperitoneal approach with a multichannel single port using conventional instruments. Nevertheless, the safety of this procedure (compared to conventional laparoscopic approach) needs to be explored in a further larger study.

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