A New Operative Telesurgical System: Telelap Alf-X - Experimental Study on Animal Model

Abstract

Objective: To report the first surgical thoracic major procedure performed using a new robotic telesurgical device (TELE-LAP ALF-X) in the ovine model.

Materials: The new operative-system has two innovative peculiarities: tactile perception (similar to tactile feedback of thoracoscopy) and eye tracking (the immediate and perfect synchronization between the surgeon eyes and the Robot-camera).

Results: After a careful setting of the robotic device, we have performed a lower-right lobectomy under complete robotic-assistance. The operative time was similar to the traditional thoracoscopy. In particular after the resection of inferior pulmonary ligament, we have isolated and closed firstly the lower pulmonary vein, then the bronchus followed by the arterial branches. The vascular and bronchial resections as well as the completion of the fissure were performed with standard endoscopic staplers introduced through an utility 4cm-sized incision. The specimen was placed in an endoscopic retrieval-bag and removed through the minithoracotomy. Finally, albeit the limitations due to different anatomical landmarks, a mediastinal lymph nodal dissection was also completed. Overall operation time was 180 minutes (with estimated blood loss of 100ml). The cooperation between the “first-operator” (placed at computer-console) and the “second-operator” (placed at the surgical-theatre) was optimal and no technical difficulties occurred.

Conclusions: According to this first experimental experience, we may assume that robotic thoracic procedures, using Tele-Lap Alf-X system, could be technical feasible in the ovine model. Although more “in vivo” experimental data are needed, we believe that robot-assisted telesurgery approach could be reasonable an innovative contribution in the near future also in human model.