Robotic endoscopic surgery in a porcine model of the infant neck |
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Authors: | Russell A Faust Adrien J Kant Attila Lorincz Abbas Younes Elizabeth Dawe Michael D Klein |
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Institution: | (1) Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Street, Detroit, MI 48201, USA |
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Abstract: | Minimally invasive surgery is rapidly becoming the desired surgical standard, especially for pediatric patients. Infants and
children are a particular technical challenge, however, because of the small size of target anatomical structures and the
small surgical workspace. Computer-assisted robot-enhanced surgical telemanipulators may overcome these challenges by facilitating
surgery in a small workspace. We studied the feasibility of performing robotic endoscopic neck surgery on a porcine model
of the human infant neck. The study design was a prospective, feasibility pilot study of a small cohort for proof of concept
and for a survival model. Sixteen non-survival piglets weighing 4.5–10 kg were used to develop the surgical approach and operative
technique. Eight piglets aged 3–6 weeks old and weighing 4.0–9.1 kg underwent survival thyroidectomy by a cervical endoscopic
approach using the Zeus surgical robot, which includes the Aesop endoscope holder and “Microwrist” microdissecting instruments.
We succeeded in performing endoscopic robotic neck surgery on a piglet as small as 4 kg, in an operative pocket as small as
2 cm3. Total incision length for all three ports was ≤23 mm. There were no major complications, no major robotic instrument malfunctions
or breakages, and no procedures required conversion to open surgery. These results support the feasibility of robotic endoscopic
neck surgery on a neck the size of a human infant’s.
Electronic supplementary material The online version of this article (doi: ) contains supplementary material, which is available to authorized users. |
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Keywords: | Endoscopy/endoscopic Infant Neck dissection Pediatric Robot Robotic surgery Thyroidectomy Aesop Hermes Zeus |
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