Stray energy transfer in single-incision robotic surgery.

Autor: Wikiel KJ; Department of Surgery, the University of Colorado School of Medicine & the Denver Veterans Affairs Medical Center, Aurora, CO, USA. Krzysztof.Wikiel@CUAnschutz.edu.; Rocky Mountain Regional Veterans Affairs Medical Center, 1700 North Wheeling St, Mail Stop 112, Aurora, CO, 80045, USA. Krzysztof.Wikiel@CUAnschutz.edu., Overbey DM; Department of Surgery, the University of Colorado School of Medicine & the Denver Veterans Affairs Medical Center, Aurora, CO, USA.; Department of Surgery, Duke University, Durham, NC, USA., Carmichael H; Department of Surgery, the University of Colorado School of Medicine & the Denver Veterans Affairs Medical Center, Aurora, CO, USA., Chapman BC; Department of Surgery, the University of Colorado School of Medicine & the Denver Veterans Affairs Medical Center, Aurora, CO, USA.; Department of Surgery, University of Tennessee College of Medicine, Chattanooga, TN, USA., Moore JT; Department of Surgery, the University of Colorado School of Medicine & the Denver Veterans Affairs Medical Center, Aurora, CO, USA.; Rocky Mountain Regional Veterans Affairs Medical Center, 1700 North Wheeling St, Mail Stop 112, Aurora, CO, 80045, USA., Barnett CC; Department of Surgery, the University of Colorado School of Medicine & the Denver Veterans Affairs Medical Center, Aurora, CO, USA.; Rocky Mountain Regional Veterans Affairs Medical Center, 1700 North Wheeling St, Mail Stop 112, Aurora, CO, 80045, USA., Jones TS; Department of Surgery, the University of Colorado School of Medicine & the Denver Veterans Affairs Medical Center, Aurora, CO, USA.; Rocky Mountain Regional Veterans Affairs Medical Center, 1700 North Wheeling St, Mail Stop 112, Aurora, CO, 80045, USA., Robinson TN; Department of Surgery, the University of Colorado School of Medicine & the Denver Veterans Affairs Medical Center, Aurora, CO, USA.; Rocky Mountain Regional Veterans Affairs Medical Center, 1700 North Wheeling St, Mail Stop 112, Aurora, CO, 80045, USA., Jones EL; Department of Surgery, the University of Colorado School of Medicine & the Denver Veterans Affairs Medical Center, Aurora, CO, USA.; Rocky Mountain Regional Veterans Affairs Medical Center, 1700 North Wheeling St, Mail Stop 112, Aurora, CO, 80045, USA.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2021 Jun; Vol. 35 (6), pp. 2981-2985. Date of Electronic Publication: 2020 Jun 26.
DOI: 10.1007/s00464-020-07742-x
Abstrakt: Introduction: Stray energy transfer from surgical monopolar radiofrequency energy instruments can cause unintended thermal injuries during laparoscopic surgery. Single-incision laparoscopic surgery transfers more stray energy than traditional laparoscopic surgery. There is paucity of published data concerning stray energy during single-incision robotic surgery. The purpose of this study was to quantify stray energy transfer during traditional, multiport robotic surgery (TRS) compared to single-incision robotic surgery (SIRS).
Methods: An in vivo porcine model was used to simulate a multiport or single-incision robotic cholecystectomy (DaVinci Si, Intuitive Surgical, Sunnyvale, CA). A 5 s, open air activation of the monopolar scissors was done on 30 W and 60 W coag mode (ForceTriad, Covidien-Medtronic, Boulder, CO) and Swift Coag effect 3, max power 180 W (VIO 300D, ERBE USA, Marietta, GA). Temperature of the tissue (°C) adjacent to the tip of the assistant grasper or the camera was measured with a thermal camera (E95, FLIR Systems, Wilsonville, OR) to quantify stray energy transfer.
Results: Stray energy transfer was greater in the SIRS setup compared to TRS setup at the assistant grasper (11.6 ± 3.3 °C vs. 8.4 ± 1.6 °C, p = 0.013). Reducing power from 60 to 30 W significantly reduced stray energy transfer in SIRS (15.3 ± 3.4 °C vs. 11.6 ± 3.3 °C, p = 0.023), but not significantly for TRS (9.4 ± 2.5 °C vs. 8.4 ± 1.6 °C, p = 0.278). The use of a constant voltage regulating generator also minimized stray energy transfer for both SIRS (0.7 ± 0.4 °C, p < 0.001) and TRS (0.7 ± 0.4 °C, p < 0.001).
Conclusions: More stray energy transfer occurs during single-incision robotic surgery than multiport robotic surgery. Utilizing a constant voltage regulating generator minimized stray energy transfer for both setups. These data can be used to guide robotic surgeons in their use of safe, surgical energy.
Databáze: MEDLINE
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