So Hyun Kang, Yo-Seok Cho, Sa-Hong Min, Young Suk Park, Sang-Hoon Ahn, Do Joong Park, Hyung-Ho Kim. Seoul National University Bundang Hospital
Purpose: This report describes the benefits and drawbacks in the use of a novel articulating device (Artisential), which has a multi-degree wrist freedom like the Davinci endowrist, in performing complete single-port D2 lymph node dissection (LND) in single-incision distal gastrectomy (SIDG).
Methods: The Artisential was used in performing SIDG with D2 LND for patients with advanced gastric cancer. All operations were performed by a single surgeon using a three-dimensional camera and a passive scope holder in place of a scopist. The Artisential was used mainly in the 4sb and suprapancreatic LND, an area that is relatively far from the single port. In certain cases when the pancreas needed to be pushed down, such as obese male patients, the intraabdominal organ retractor was used to lift the tissue and the Artisential to push the pancreas. Operative results and short-term outcome were analyzed.
Results: Twelve patients underwent the procedure without any intraoperative events, conversion to conventional laparoscopy, or surgery-related complications including postoperative pancreatic fistula. All patients underwent single port D2 LND by complete exposure of the portal and splenic vein. Mean operation time was 181.9±42.5 mins. and mean number of retrieved lymph nodes was 61.8±11.4. The Artisential was found to be useful in grasping the tissues behind the pancreas and the major arteries throughout most of the LND. The articulating motion also allowed the narrow single-port field of view to be clearly seen without the instrument body obstructing the camera.
Conclusion: The use of Artisential in SIDG appears feasible and reproducible, and is mandatory in performing a complete D2 LND in SIDG.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93184
Program Number: V333
Presentation Session: Video Loop Day 3
Presentation Type: VideoLoop