title: Telerobotic-assisted laparoscopic cholecystectomy: our experience on 29 patients.
abstract: OBJECTIVE
  The role of computer-assisted surgery (CAS) is still debated and not clearly defined.
  
  
  METHODS
  The authors report their initial experience with CAS, comparing 29 patients submitted to cholecystectomy, using a Zeus remote-controlled robot and an Aesop remote voice-activated endoscope robot, with 29 patients submitted to standard laparoscopic cholecystectomy (LC). The surgical field and the arms of the robot were under the direct and real-time control of the surgeon, who stayed at the workstation and maneuvered the Zeus, using joysticks. The workstation was in the same room as the patient.
  
  
  RESULTS
  Twenty-nine patients underwent telerobotic-assisted cholecystectomy (TLAC); 1 procedure was converted to standard LC and 1 to open cholecystectomy. The conversions were due to choledocholithiasis and cholecystitis. During TLAC, the mean operating time and transition time (from the induction of anesthesia to incision of the skin) were, respectively, 75 min (range, 60-170 min) and 45 min (range, 25-60 min). We did not observe any complications related to TLAC. The limitations of TLAC were the lack of tactile feedback, the increase in surgical time, and the expensive cost of the procedure to reach the same result as that of LC.
  
  
  CONCLUSIONS
  After this initial experience, we believe that TLAC could be considered only for training in CAS, but that it is without advantages in terms of its higher cost compared with LC.
authors.affiliation: Fourth Unit of Surgery, Regional Reference Center of Hepato-Biliary-Pancreatic Surgery, Regional Hospital Cà Foncello Piazza Ospedale, 31100, Treviso, Italy.
authors.forename: Ezio
authors.initials: E
authors.lastname: Caratozzolo
authors.forename: Alfonso
authors.initials: A
authors.lastname: Recordare
authors.forename: Marco
authors.initials: M
authors.lastname: Massani
authors.forename: Luca
authors.initials: L
authors.lastname: Bonariol
authors.forename: Alessandro
authors.initials: A
authors.lastname: Jelmoni
authors.forename: Michele
authors.initials: M
authors.lastname: Antoniutti
authors.forename: Nicolò
authors.initials: N
authors.lastname: Bassi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic / Q000191:economics / Q000379:methods*; D002764:Cholecystitis / Q000150:complications; D042883:Choledocholithiasis / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012371:Robotics / Q000191:economics / Q000295:instrumentation / Q000379:methods*