title: Robot-assisted minimally invasive Kasai portoenterostomy: a survival porcine study.
abstract: 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.
authors.affiliation: 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.
authors.forename: A
authors.initials: A
authors.lastname: Lorincz
authors.forename: C G
authors.initials: CG
authors.lastname: Knight
authors.forename: S E
authors.initials: SE
authors.lastname: Langenburg
authors.forename: R
authors.initials: R
authors.lastname: Rabah
authors.forename: K
authors.initials: K
authors.lastname: Gidell
authors.forename: E
authors.initials: E
authors.lastname: Dawe
authors.forename: S
authors.initials: S
authors.lastname: Grant
authors.forename: M D
authors.initials: MD
authors.lastname: Klein
mesh_terms: 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