Technical assessment of porcine enteroenterostomy performed with ZEUS™ robotic technology

Background/Purpose: Limitations of minimally invasive pediatric surgery include the inability to perform precise anastomoses of 2 to 15 mm. Robotic technology facilitates the performance of endoscopic microsurgical procedures. This study examined the technical feasibility of performing an enteroenterostomy in piglets utilizing ZEUS™ robotic technology. Methods: Ten piglets (6.5 to 8.5 kg) underwent enteroenterostomy. Standard laparoscopic techniques were used in the control group (n = 5), and ZEUS™ robotic technology was used in the experimental group (n = 5). AESOP controlled the camera in both groups. Anesthesia time; surgery time; robotic set-up time; and anastomotic time, patency, diameter, and integrity were compared. Results: No statistical difference existed between the means of the control and experimental groups for anesthesia time (176.0 v 154.0 minute; P =.63), surgery time (143.0 v 139.2 minute; P=.92), anastomosis time (109.4 v93.0 minutes; P =.56), AESOP set-up time (4.2 v 7.0 minutes; P =.51), and anastomotic diameter (7.062 v 7.362 mm; P =.62). All anastomoses were patent without narrowing. The ZEUS™ cases averaged 14 minutes faster than the standard laparoscopic cases, even with the ZEUS™ set-up time included. Conclusions: These data supports the hypothesis that robotic-assisted enteroenterostomy is technically feasible. ZEUS™ robotic technology will potentially play an important role in expanding the applications of minimally invasive pediatric surgery.