Usefulness of articulating laparoscopic instruments during laparoscopic gastrectomy for gastric adenocarcinoma

Eunju Lee, Kanghaeng Lee, So Hyun Kang, Sangjun Lee, Yongjoon Won, Young Suk Park, Sang-Hoon Ahn, Yun-Suhk Suh, Hyung-Ho Kim, Eunju Lee, Kanghaeng Lee, So Hyun Kang, Sangjun Lee, Yongjoon Won, Young Suk Park, Sang-Hoon Ahn, Yun-Suhk Suh, Hyung-Ho Kim

Abstract

Purpose: Conventional straight-shaped laparoscopic surgical instruments have limitations that, unlike robotic surgery, the wrist joint cannot be used. This study aimed to analyze the short-term safety and feasibility of ArtiSential (Livsmed), a new articulating laparoscopic instrument, which obviates the limitations of conventional laparoscopic surgery and allows the wrist joint to be used freely over 360° as in robotic surgery.

Methods: The study included patients who underwent conventional laparoscopy or laparoscopy with the ArtiSential instrument. Patients who underwent laparoscopic gastrectomy for primary gastric adenocarcinoma in our institution were retrospectively reviewed. The groups were propensity score matched in a 11 ratio. Primary endpoint was incidence of early postoperative complication (postoperative 30-day morbidity and mortality) and secondary endpoints were operative outcomes.

Results: A total of 327 patients (147 of the conventional group and 180 of the ArtiSential group) were propensity score matched. After propensity score matching was performed, each group comprised of 122 patients. Both groups were comparable with regard to operation time, estimated blood loss, number of retrieved lymph nodes, and length of hospital stay. The ArtiSential group had a faster time to a fluid diet (2.6 ± 1.3 days vs. 2.3 ± 0.6 days, p = 0.015). There was no statistically significant difference in early postoperative complications between the two groups (the conventional group, 23.0%; the ArtiSential group, 26.2%; p = 0.656).

Conclusion: The current study showed that the use of ArtiSential is a safe and feasible option without increasing operation time, length of hospital stay, and intraoperative bleeding.

Keywords: Articulation; Gastrectomy; Laparoscopy; Stomach neoplasms.

Conflict of interest statement

All authors have no conflicts of interest to declare.

Copyright © 2021 The Journal of Minimally Invasive Surgery. All rights reserved.

Figures

Fig. 1
Fig. 1
Port placement for the conventional group and the ArtiSential group. ArtiSential: Livsmed, Seongnam, Korea; EZ Access: Hakko, Tokyo, Japan.
Fig. 2
Fig. 2
No. 12 lymph node dissection using the fenestrated forceps (ArtiSential; Livsmed, Seongnam, Korea).
Fig. 3
Fig. 3
Operation time of laparoscopic distal gastrectomy in chronological order. ArtiSential: Livsmed, Seongnam, Korea.

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