Robotic-assisted laparoscopic Roux-en-Y choledochojejunostomy in pigs.
OBJECTIVE
We aimed to investigate the feasibility of robotic-assisted laparascopic reconstruction of the common bile duct (CBD) by way of Roux-en-Y choledochojejunostomy, given an operator with no prior robotic skills.


METHODS
Ten pigs, of 75 kg median weight, were used for the experiments. Three of these animals were used to initialize and adjust the procedure, and seven were scheduled for postoperative survival of a week, and subsequent laparotomy for evaluation. The gallbladder was removed and a Roux-en-Y choledochojejunostomy was done. Blood samples were drawn prior to the first and the final operation. Under laparotomy, the animals were investigated for signs of cholascos and intraoperative cholangiography was performed.


RESULTS
All pigs showed competent anastomoses upon evaluation, including two pigs, which died on the fourth and fifth postoperative days, respectively, due to incorrect suspension of the Roux-en-Y sling, resulting in gastric retention. Standard liver parameters were not affected by surgery, and cholangiography showed no signs of extrahepatic stenosis or intrahepatic dilatation.


CONCLUSIONS
Robotic-assisted Roux-en-Y choledocho-jejunostomy is an easy procedure and accomplishes biliary drainage and intact intestinal flow. Decreasing operating times were experienced, approximating those of a skilled operator.
Laursen
Henrik Blegvad
HB
Department of Gastrointestinal Surgery L, Section AKH, Aarhus University Hospital, 8000, Aarhus C, Denmark.
Thorsøe
Hans Jakob
HJ
Funch-Jensen
Peter
P
Rokkjaer
Mogens
M
Yasuda
Yoshikazu
Y
Mortensen
Frank Viborg
FV
D000713:Anastomosis, Roux-en-Y; D000818:Animals; D002758:Cholangiography; D002768:Choledochostomy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D010535:Laparoscopy / Q000379:methods*; D012371:Robotics / Q000379:methods*; D013552:Swine