A Feasibility Study and Technical Tips for the Use of an Articulating Bipolar Vessel Sealer in da Vinci Robot-Assisted Gastrectomy

作者:Kong Seong Ho; Kim Tae Han; Huh Yeon Ju; Oh Seung Young; Ahn Hye Seong; Park So Yong; Choi Yun Suk; Suh Yun Suhk; Lee Hyuk Joon; Yang Han Kwang*
来源:Journal of Laparoendoscopic & Advanced Surgical Techniques, 2017, 27(11): 1172-1179.
DOI:10.1089/lap.2017.0093

摘要

Background: The aim of this study was to evaluate the efficacy and safety of a new articulating bipolar energy device, the EndoWrist((R)) One Vessel Sealer (VS), in da Vinci((R)) robot-assisted gastrectomy. Materials and Methods: Patients (n=17) with cT1/2 gastric cancer who underwent robotic gastrectomy using the VS were prospectively enrolled in the study group (VS group). The clinicopathological outcomes, including operative time, intraoperative blood loss, amount of postoperative drainage, postoperative biochemical analysis results, and complication rates, were prospectively collected and compared with those of patients who underwent robotic gastrectomy using conventional ultrasonic shear force ([US] group, n=52) during the same time period. Results: Although the VS provided a good direction for dissection because of the articulating function, the ancillary use of conventional bipolar coagulation was occasionally needed due to the blunt, nonactive end tip of the VS. The operative time, intraoperative blood loss, postoperative drainage, and absence of complication rates did not differ between the VS and US groups, but the C-reactive protein levels on the second postoperative day (8.06 versus 11.7, P=.002) and serum albumin levels on the fifth postoperative day (3.51 versus 3.32, P=.019) were superior in the VS group. Conclusion: Use of the VS in robotic gastrectomy was feasible and provided good configuration in the direction of dissection. The learning process for use of the VS in the initial series was relatively rapid, resulting in comparable results between the VS and US groups. Reduced inflammation and albumin loss were identified as possible benefits of the VS.

  • 出版日期2017-11