Tomorrow’s Surgical Robots Promise New Options: Dual-Field Synchronous Transanal Total Mesorectal Excision (taTME) in a Preclinical Model Using the Versius Surgical System

Sam B Atallah¹, Eduardo Parra-Davila², Armando Melani³. ¹HCA Oviedo Medical Center, ²Good Samaritan Hospital, ³IRCAD Brazil

Objective: To evaluate the feasibility of the Versius surgical robotic system for transanal total mesorectal excision (taTME) in a preclinical setting.

Application: Robotic, dual-field abdominal and transanal synchronous access was obtained using the modular configuration of the Versius surgical robotic system with two surgeons operating simultaneously at separate consoles to perform taTME in a cadaveric model.  This novel platform allows for an application whereby surgeons may operate robotically and in synchronicity in separate anatomical fields, thereby potentially reducing operative time and operating cost.

Preliminary Results: Dry laboratory and Cadaveric sessions were first conducted by three experienced colorectal surgeons in order to gain familiarity with the modular surgical system and the robotic workstation.  After introduction, the system was configured to allow for synchronous taTME.  Using the modular Versius robotic system, one surgeon performed the abdominal portion of the operation, including colonic mobilization and vascular pedicle ligation;  simultaneously a second surgeon performed the transanal portion of the operation to the point of rendezvous at the peritoneal reflection, where the operation was completed in synchronicity.  The abdominal surgeon utilized four Versius working robotic arms, while the transanal surgeon, working through a TAMIS-based interface, utilized three working arms. In order to function independently, both setups included separate robotic-controlled stereoscopic cameras, one for each surgeon. The operation was successfully completed demonstrating preclinical feasibility of this unique approach with an emerging robotic system. 

Conclusion: This is the first preclinical assessment of the Versius surgical robotic system for taTME. Operating in two fields represents an altogether new option for surgical robotics. The ability to work simultaneously carries the theoretical advantage of reducing surgical time and thereby reducing overall operative costs.  It may also allow surgeons to maintain focus on critical parts of the operation by halving the fatigue associated with long, complex cases such as taTME.

Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 98664

Program Number: ET008

Presentation Session: Emerging Technology Session

Presentation Type: Podium