Robotic-assisted laparoscopic cholecystojejunostomy

Surgical laparoscopic robotic systems have been developed to transfer time- consuming, repetitive tasks from human to robot, thus increasing safety and improving surgical outcome. Laparoscopic cholecystojejunostomy for unresec table pancreatic cancer has become widely accepted. The main manipulation o f this operation is suturing, which could possibly be done with robotic ass istance. The aim of this study was to assess the feasibility and the techni cal aspects of robotic-assisted laparoscopic cholecystojejunostomy. Sixteen pigs were divided into two groups of eight. Robotic-assisted laparoscopic cholecystojejunostomy (Roux-Y anastomosis) was performed in one group of an imals (Group RLC). The second group was used as control and underwent a lap aroscopic cholecystojejunostomy using the ordinary laparoscopic instruments , except with robotic camera control (Group LC). Laparotomy and fluoroscopi c examination were performed postoperatively. Animals in both groups tolera ted the operations well. There was no significant difference in set-up time between groups. The operative time and the time for completing the two ana stomoses were significantly longer in the RLC group. There was no leakage a fter anastomoses in any animal, as confirmed by laparotomy and fluoroscopy. Robotic-assisted laparoscopic cholecystojejunostomy is technically feasibl e. Stable images and comfortable manipulation can be obtained using this te chnique. One or two surgeons can perform this operation, assisted by the ro botic system. The main disadvantages are longer operative time and the use of expensive devices. With improvements in robotic instruments and techniqu es, the operative time will be decreased and the technology could become wi dely accepted.