Robotically assisted small intestinal strictureplasty in dogs: a survival study involving 16 Heineke-Mikulicz strictureplasties.
BACKGROUND
Robotically assisted surgery offers the advantages of improved dexterity and elimination of tremor over conventional laparoscopic surgery. There have been few studies to date, however, examining the role of robotics in intestinal surgery. This study was undertaken to determine the feasibility and safety of using a robotic surgical system in the performance of intracorporeal small bowel strictureplasties in dogs.


METHODS
Using a robotic surgical system, a total of 16 strictureplasties were performed in the small bowel of eight dogs (two strictureplasties per dog). Using only intracorporeal robotic surgery, a 2.5 cm enterotomy was made longitudinally in the small bowel, and then closed in a Heineke-Mikulicz configuration with a one-layer running 3-0 braided absorbable suture (strictureplasty). All animals were allowed to survive for 7 days with prospective monitoring of bowel movements, level of activity, oral intake, and abdominal examination. After 7 days, necropsy was performed, examining all strictureplasty sites for signs of sepsis. The endpoints of the study were recovery of normal intestinal function (bowel movements), intraoperative and postoperative complications, and the appearance of the anastomoses at necropsy.


RESULTS
There was no intraoperative morbidity or mortality. All eight dogs survived 7 days and recovered well. All dogs had a bowel movement on the first postoperative day, and appeared healthy throughout the study period. Necropsy revealed that all 16 strictureplasty sites were healing without signs of sepsis. The median time per strictureplasty was 65 min (range, 45-110 min). One dog developed a superficial wound infection at a trocar site.


CONCLUSIONS
A robotic surgical system can successfully be employed in the performance of intestinal strictureplasties in dogs. This study supports further investigation into the role of robotics in intestinal surgery in humans.
Sonoda
T
T
Section of Colon and Rectal Surgery, New York Presbyterian Hospital, Weill Medical College of Cornell University, 525 East 68th Street, Box 172, New York, New York 10021, USA. tos2003@med.cornell.edu
Lee
S
S
Whelan
R L
RL
Le
D
D
Foglia
C
C
Venturero
M
M
Hunt
D
D
Nakajima
K
K
Milsom
J W
JW
D000818:Animals; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D004285:Dogs; D005240:Feasibility Studies; D007415:Intestinal Obstruction / Q000503:physiopathology / Q000601:surgery*; D007421:Intestine, Small / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D020127:Recovery of Function; D012371:Robotics; D013530:Surgical Wound Infection; D016019:Survival Analysis; D013997:Time Factors; D014945:Wound Healing