Robot-assisted minimally invasive Kasai portoenterostomy: a survival porcine study.
BACKGROUND
Major enhancements offered by robotic surgery for minimally invasive procedure include tremor filtration, motion scaling, and the addition of a wrist to the instrument. Minor enhancements include indexing as well as safe and rapid instrument exchange. A benefit associated with any endoscopic procedure is magnification. It was hypothesized that these enhancements would allow the performance of complex gastrointestinal surgery.


METHODS
Eight survival pigs (weight, 2.5-8 kg) underwent a robotically assisted minimally invasive portoenterostomy. The procedure was analogous to the Kasai portoenterostomy for biliary atresia usually performed for human patients at the age of 4 to 12 weeks.


RESULTS
Five of the eight animals survived for more than 1 month after the operation, returning to normal eating and bowel habits in 2 to 3 days. None were jaundiced. All laboratory values were normal. At 1 month, the animals were killed. There was no anastomotic stenosis at either the end-to-side enteroenterostomy or the portoenterostomy. Histologically, the anastomoses were well healed.


CONCLUSIONS
Computer-assisted robot-enhanced technology allows complex gastrointestinal surgery to be performed using minimally invasive techniques.
Lorincz
A
A
Department of Surgery, Wayne State University School of Medicine and Children's Hospital of Michigan, Children's Research Center of Michigan, Detroit, MI 48201, USA.
Knight
C G
CG
Langenburg
S E
SE
Rabah
R
R
Gidell
K
K
Dawe
E
E
Grant
S
S
Klein
M D
MD
D000818:Animals; D000831:Animals, Newborn; D004867:Equipment Design; D007415:Intestinal Obstruction / Q000209:etiology; D007858:Learning; D019060:Minimally Invasive Surgical Procedures; D010538:Peritonitis / Q000209:etiology; D011171:Portoenterostomy, Hepatic / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D012371:Robotics; D034421:Sus scrofa; D014945:Wound Healing