Does robotic assistance improve efficiency in performing complex minimally invasive surgical procedures?

OBJECTIVE: We developed a model of biliary-enteric anastomosis to test whether assistance with the da Vinci surgical system, as compared to laparoscopy alone, improves performance on a complex minimally invasive surgical (MIS) procedure. METHODS: An ex vivo model for choledocho-jejunostomy was created using specimens of porcine liver that included an intact extrahepatic biliary system and a contiguous loop of proximal intestine. Minimally invasive choledocho-jejunostomies were performed in two experimental arms: Group 1 (laparoscopic) 25 cases; Group 2 (da Vinci-assisted) 24 cases. All procedures were performed by three surgeons with graduated expertise in MIS: Surgeon A (MIS and robotic focus); Surgeon B (experienced MIS); Surgeon C (basic MIS). Each surgeon performed equivalent numbers of procedures in each group. The primary objective was comparison of time to complete anastomosis using da Vinci and laparoscopic approaches. Secondary objectives included anastomosis quality and integrity and impact of experience on performance. RESULTS: Da Vinci assistance led to significantly faster time to complete anastomosis than laparoscopy (28.6 vs. 38 min, p

Session: Poster

Program Number: P390

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