Use of the Soft Coagulation Scissors (SoCS) Method Combining Soft Coagulation With Curved Scissors in Robot-Assisted Colorectal Surgery

Abstract

Introduction: Robot-assisted surgery has become increasingly common in colorectal cancer, facilitating precise procedures due to features such as multijointed instruments and motion scaling in a high-resolution three-dimensional field. These advantages are useful in lymph node dissection, where cautious and multidirectional manipulation is required for a complex vascular anatomy. Lymph node dissection involves close manipulation of the vessel wall and entails precise manipulation. Robotic surgery typically utilizes a combination of curved scissors and an electrocautery generator. However, this strategy may damage vessel walls and cause bleeding when the scissors come in contact with them. To prevent such risks, this study developed the soft coagulation scissors (SoCS) method, which is a combination of soft coagulation and curved scissors, in robot-assisted surgery.

Materials and surgical technique: The SoCS method is a novel coagulation and dissection technique that has the advantage of soft coagulation characteristics. The soft coagulation mode suppresses the spark discharge by controlling the voltage and denatures proteins using only Joule heat, resulting in hemostasis. As there is no spark discharge, soft coagulation cannot be used to incise the tissue. Thus, the tissue must be physically cut with curved scissors, resulting in sharp dissection. Even if the curved scissors come in contact with the vessel wall and coagulate it, they will not cause damage and bleeding.

Discussion: The SoCS technique has a high hemostatic efficacy, can facilitate precise dissection, and has enhanced safety near blood vessels. Therefore, it is a valuable addition to robot-assisted surgical procedures.

Keywords: colorectal cancer; robot‐assisted surgery; soft coagulation.