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Robotic TAMIS: A Technical Note Comparing Si (R) versus Xi (R)
Westchester Med Ctr, NY 10595 USA.
Yeditepe Univ Hosp, Turkey.
Med Univ Vienna, Austria.
Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
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2021 (English)In: SURGICAL TECHNOLOGY INTERNATIONAL-INTERNATIONAL DEVELOPMENTS IN SURGERY AND SURGICAL RESEARCH, ISSN 1090-3941, Vol. 38, article id 1421Article in journal (Refereed) Published
Abstract [en]

Transanal minimally invasive surgery (TAMIS) can be performed robotically assisted (R-TAMIS) for easier rectal defect suture closure particularly on the anterior rectal wall. The surgical technique described in this technical note emphasizes three safety points: 1) decreased likelihood for rectal injury when the ports are inserted into the GelPOINT (R) Path Transanal Access Platform (Applied Medical, Rancho Santa Margarita, California) on the back table rather than being inserted into the rectum; 2) decreased external collision between ports when using ports of different length; and 3) increased stabilization of pneumorectum when insufflating with an AirSeal (TM) port (Intelligent Flow System, ConMed, Utica, New York). Although R-TAMIS can be safely performed with the da Vinci (R) Si (R) or Xi (R) (Intuitive Surgical Inc., Sunnyvale, California) patient cart, the following differences are noteworthy: a) the Si (R) vertically-mounted arms design forces the patient in an uncomfortable position with asymmetrical hip flexion as opposed to the Xi (R) boom-mounted horizontal arm design; b) the 28cm circumference of each Si (R) patient cart arms operating between the patients legs offer decreased maneuvering freedom as opposed to the 19cm circumference of the Xi (R) counterparts; and c) the abduction pattern of movement of the Si (R) arms potentially increases the risk of external collision with the patients legs as opposed to the Xi (R) "jack-knife" pattern of movement.

Place, publisher, year, edition, pages
SURGICAL TECHNOLOGY INT ONLINE , 2021. Vol. 38, article id 1421
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-180002DOI: 10.52198/21.STI.38.CR1421ISI: 000661729000021PubMedID: 33942885OAI: oai:DiVA.org:liu-180002DiVA, id: diva2:1602115
Available from: 2021-10-11 Created: 2021-10-11 Last updated: 2021-10-11

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