Yonsei Med J.  2017 Sep;58(5):1075-1077. 10.3349/ymj.2017.58.5.1075.

Robotic Cholecystectomy Using the Newly Developed Korean Robotic Surgical System, Revo-i: A Preclinical Experiment in a Porcine Model

• Kang CM
• Chong JU
• Lim JH
• Park DW
• Park SJ
• Gim S
• Ye HJ
• Kim SH
• Lee WJ

• KMID: 2418950
• DOI: http://doi.org/10.3349/ymj.2017.58.5.1075

Abstract

One Korean company recently successfully produced a robotic surgical system prototype called Revo-i (MSR-5000). We, therefore, conducted a preclinical study for robotic cholecystectomy using Revo-i, and this is a report of the first case of robotic cholecystectomy performed using the Revo-i system in a preclinical porcine model. Revo-i consists of a surgeon console (MSRC-5000), operation cart (MSRO-5000) and vision cart (MSRV-5000), and a 40 kg-healthy female porcine was prepared for robotic cholecystectomy with general anesthesia. The primary end point was the safe completion of these procedures using Revo-i: The total operation time was 88 minutes. The dissection time was defined as the time from the initial dissection of the Calot area to the time to complete gallbladder detachment from the liver bed: The dissection time required 14 minutes. The surgical console time was 45 minutes. There was no gallbladder perforation or significant bleeding noted during the procedure. The porcine survived for two weeks postoperatively without any complications. Like the da Vinci surgical system, the Revo-i provides a three-dimensional operative view and allows for angulated instrument motion (forceps, needle-holders, clip-appliers, scissors, bipolar energy, and hook monopolar energy), facilitating an effective laparoscopic procedure. Our experience suggests that robotic cholecystectomy can be safely completed in a porcine model using Revo-i.

Keyword

Robotic surgical procedure; cholecystectomy; device approvals

MeSH Terms

Animals
Cholecystectomy/*methods
Female
Models, Animal
Operative Time
Republic of Korea
Robotic Surgical Procedures/*methods
Swine

Figure

• 

  Fig. 1 Ports positioning. 1.5 cm incision was made for camera port around umbilicus. Other robotic ports were positioned approximately 10 cm from each other to reduce fighting between the arms. 8 mm incisions were made on A-arm, B-arm, and C-arm. 1 cm incision was made on assist port.

Reference

1. Lee WJ, Chan CP, Wang BY. Recent advances in laparoscopic surgery. Asian J Endosc Surg. 2013; 6:1–8.

2. National Institutes of Health Consensus Development Conference Statement on Gallstones and Laparoscopic Cholecystectomy. Am J Surg. 1993; 165:390–398.

3. Satava RM. Surgical robotics: the early chronicles: a personal historical perspective. Surg Laparosc Endosc Percutan Tech. 2002; 12:6–16.

4. Giulianotti PC, Coratti A, Angelini M, Sbrana F, Cecconi S, Balestracci T, et al. Robotics in general surgery: personal experience in a large community hospital. Arch Surg. 2003; 138:777–784.

5. Szold A, Bergamaschi R, Broeders I, Dankelman J, Forgione A, Langø T, et al. European Association of Endoscopic Surgeons (EAES) consensus statement on the use of robotics in general surgery. Surg Endosc. 2015; 29:253–288.

6. Kang CM, Chi HS, Hyeung WJ, Kim KS, Choi JS, Lee WJ, et al. The first Korean experience of telemanipulative robot-assisted laparoscopic cholecystectomy using the da Vinci system. Yonsei Med J. 2007; 48:540–545.