title: Robotic single-incision transabdominal and transvaginal surgery: initial experience with intersecting robotic arms.
abstract: BACKGROUND
  Single-incision laparoscopic and natural orifice translumenal endoscopic surgery (NOTES) are technically challenging methods. Robotics might have the potential to overcome such hurdles with computer technology.
  
  
  METHODS
  The da Vinci Standard and S System (Intuitive, Sunnyvale, USA) were used in human cadavers and pigs to perform single-incision transabdominal and transvaginal surgery. Robotic arms were crossed and control-switched to achieve intuitive control.
  
  
  RESULTS
  It was possible to perform robotic single-incision laparoscopy in the typical, intuitive fashion. Transvaginal set-up, including docking of the system and introduction of instruments into the abdominal cavity, was possible but no useful manipulation could be performed.
  
  
  CONCLUSIONS
  While robotic NOTES with the da Vinci surgical system was not successful, robotic single-incision surgery is feasible using the above set-up. This new approach seems to offer the advantages of single-incision surgery while maintaining the intuitive control of robotic surgery. Clinical application appears justified.
authors.affiliation: Center for the Future of Surgery, Department of Surgery, University of California at San Diego, CA 92108, USA. MonikaHagen@aol.com
authors.forename: Monika E
authors.initials: ME
authors.lastname: Hagen
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Wagner
authors.forename: Ihsan
authors.initials: I
authors.lastname: Inan
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.forename: Jean
authors.initials: J
authors.lastname: Fasel
authors.forename: Garth
authors.initials: G
authors.lastname: Jacobsen
authors.forename: Adam
authors.initials: A
authors.lastname: Spivack
authors.forename: Kari
authors.initials: K
authors.lastname: Thompson
authors.forename: Brian
authors.initials: B
authors.lastname: Wong
authors.forename: Lauren
authors.initials: L
authors.lastname: Fischer
authors.forename: Mark
authors.initials: M
authors.lastname: Talamini
authors.forename: Santiago
authors.initials: S
authors.lastname: Horgan
mesh_terms: D000005:Abdomen / Q000601:surgery*; D002102:Cadaver; D004867:Equipment Design; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D014621:Vagina / Q000601:surgery*