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. 2019 Nov;33(11):3696-3703.
doi: 10.1007/s00464-018-06658-x. Epub 2019 Jan 8.

Enabling single-site laparoscopy: the SPORT platform

Barbara Seeliger  1 , Michele Diana  2 , Jelle P Ruurda  3 , Konstantinos M Konstantinidis  4 , Jacques Marescaux  2 , Lee L Swanström  2   5
Affiliations

Enabling single-site laparoscopy: the SPORT platform

Barbara Seeliger et al. Surg Endosc. 2019 Nov.

Abstract

Background: The Single Port Orifice Robotic Technology (SPORT) Surgical System by Titan Medical Inc. is designed to overcome the inherent challenges of minimally invasive single-access procedures. The aim of this preclinical study was to evaluate the feasibility of various digestive surgery procedures using this novel surgical robotic platform.

Methods: A total of 12 minimally invasive procedures were performed on six pigs (5 cholecystectomies, 3 Nissen fundoplications, 1 splenectomy and 1 hepatic pedicle dissection) and on one human cadaver (1 cholecystectomy and 1 Nissen fundoplication), by four laparoscopic surgeons. The usability of the device was assessed by means of the modified objective structured assessment of technical skills (OSATS) score that was calculated and analyzed by two independent observers on the recorded videos. Surgeon feedback and recommendations were systematically recorded.

Results: All procedures were successfully completed with the SPORT system. In general, surgeons reported to appreciate the intuitive interface and controls, the high-resolution 3D imaging, the dexterity of the end-effectors, and the ergonomic open control platform. Some features requiring optimization were also identified. The modified OSATS score demonstrated a learning curve effect for all device-related tasks.

Conclusions: A variety of abdominal procedures could be safely completed with the current SPORT prototype, in the preclinical setting. This preliminary feasibility experience is promising and encourages further development of single-port robotically assisted surgery.

Keywords: Laparoscopy; Robotic surgery; SPORT™ Surgical System; Single access; Single-port surgery; Single-site.

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Conflict of interest statement

Barbara Seeliger received a travel grant to the 2018 SAGES meeting funded by Titan Medical Inc. Jelle P. Ruurda and Konstantinos M. Konstantinidis received remuneration by Titan Medical Inc. for their participation in this study, and they are proctors for Intuitive Surgical. Jacques Marescaux is the President of both IRCAD and IHU-Strasbourg Institutes, which are partly funded by Karl Storz, Medtronic and Siemens Healthcare. Lee Swanström is Scientific Director and Chief Innovation Officer of the IHU-Strasbourg and is a medical consultant for Titan Medical, Boston Scientific, Olympus, and Apollo Endosurgery. Michele Diana has no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Operating room set-up for a Nissen fundoplication in the porcine model. A Patient cart with a single support boom for the CU, which is docked to the CIT. B Insertion of the two surgical instruments via the CIT. C Surgeon position at the workstation. D The open surgeon workstation design allows direct interaction in the operating theatre
Fig. 2
Fig. 2
Docking procedure: the CIT is introduced through the gel access port and connected to the CU
Fig. 3
Fig. 3
Assistant introducing a standard laparoscopic instrument through an additional assistant port. The port distance to the CIT and CU allows for a large motion range
Fig. 4
Fig. 4
Individual analysis of modified OSATS score revealed an overall learning curve effect represented by an increasing percentage of total score with every performed procedure. Procedures are represented as follows: C (cholecystectomy), F (fundoplication), H (hepatic pedicle dissection), S (half splenectomy). Cadaveric procedures are underlined
See this image and copyright information in PMC

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