Robotically assisted laparoscopic Roux-en-Y hepaticojejunostomy.
BACKGROUND
This study evaluates the feasibility and safety of using robotically assisted laparoscopy to perform a Roux-en-Y hepaticojejunostomy. This new method was compared with the open and standard laparoscopic approaches.


METHODS
Eighteen pigs underwent a needlescopic common bile duct ligation to create a jaundice model. Three to 5 days later, transabdominal ultrasound was performed, and the common bile duct diameter was documented. For the Roux-en-Y hepaticojejunostomy, the pigs were randomly assigned to the open group (n=6), standard laparoscopy group (n=6), or robotically assisted laparoscopy group (Zeus) (n=6). One surgeon performed all 3 approaches with 1 assistant. Operative times, techniques, and complication rates were documented.


RESULTS
The open approach was faster in all instances. At the hepaticojejunostomy, no difference was noted between the groups with the total number of stitches used. The robot required fewer stitches and less time in the posterior wall of the hepaticojejunostomy (P=-0.0083 and P=0.02049, respectively). The hepaticojejunostomy time was similar for the laparoscopy and robotically assisted groups.


CONCLUSIONS
Robotically assisted laparoscopic Roux-en-Y hepaticojejunostomy is a feasible procedure. When compared with standard laparoscopy, operating time is similar.
Villegas
Leonardo
L
Endosurgical Research Group, Duke University Medical Center, Durham, North Carolina, USA. LeonardoVillegas@Yahoo.com
Lagoo
Sandhya
S
Schwartz
Ted
T
Athar
Nina
N
Greene
Rebecca
R
Eubanks
W Steve
WS
D000713:Anastomosis, Roux-en-Y; D000818:Animals; D005240:Feasibility Studies; D005260:Female; D006500:Hepatic Duct, Common / Q000601:surgery; D007582:Jejunostomy; D010535:Laparoscopy; D012371:Robotics; D013552:Swine; D013997:Time Factors