Freehand-robot-assisted laparoscopic colorectal surgery: Initial experience in the Trinidad and Tobago

doi:10.5412/wjsp.v12.i1.1

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World Journal of Surgical Procedures

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World J Surg Proced. Jul 15, 2022; 12(1): 1-7
Published online Jul 15, 2022. doi: 10.5412/wjsp.v12.i1.1

Freehand-robot-assisted laparoscopic colorectal surgery: Initial experience in the Trinidad and Tobago

Shamir O Cawich, Yardesh Singh, Vijay Naraynsingh, Ramdas Senasi, Tan Arulampalam

Shamir O Cawich, Vijay Naraynsingh, Department of Surgery, University of the West Indies, St Augustine, Trinidad and Tobago

Yardesh Singh, Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago

Ramdas Senasi, Department of Surgery, South Tyneside and Sunderland NHS Trust, South Shields NE34 0PL, United Kingdom

Tan Arulampalam, Department of General Surgery, Colchester Hospital University National Health Services Foundation Trust, Colchester, Essex, England, Colchester CO4 5JL, United Kingdom

Author contributions: Cawich SO wrote the paper and reviewed the paper for scientific accuracy; Naraynsingh V and Singh Y collected data and reviewed the mansucript for accuracy; Sensai R and Arulampalam T analyzed data and reviewed the manuscript for scientific accuracy.

Institutional review board statement: The study was reviewed and approved by the University of the West Indies' Institutional Review Board [(Approval No. CREC-SA.1615/06/2022].

Informed consent statement: This was an observational study of anonymized patient records. Consequently, the Institutional Review Board reviewed the protocols and exempted the participants from individual consent.

Conflict-of-interest statement: There are no conflicts of interest declared by any of the authors.

Data sharing statement: Data are available from the corresponding author upon request.

CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.

Corresponding author: Shamir O Cawich, FRCS, Full Professor, Department of Surgery, University of the West Indies, St. Augustine Campus St. Augustine, St Augustine, Trinidad and Tobago. socawich@hotmail.com

Received: January 30, 2022
Peer-review started: January 30, 2022
First decision: March 25, 2022
Revised: May 11, 2022
Accepted: June 16, 2022
Article in press: June 16, 2022
Published online: July 15, 2022
Processing time: 163 Days and 4.1 Hours

ARTICLE HIGHLIGHTS

Research background

Laparoscopic colorectal surgery is still developing in the Anglophone Caribbean and there has been no report of robot assisted colorectal surgery in the region. This paper reports our initial experience with advanced colorectal surgery using the Freehand robot.

Research motivation

Robot-assisted colorectal surgery using the FreeHand^® robotic camera holder (Freehand 2010 Ltd., Guildford, Surrey, United Kingdom) was introduced to the Caribbean in 2021. We report our initial experience with this technology.

Research objectives

This paper reports the initial experience with the FreeHand(R) robotic camera holder to complete colorectal operations in a resource-poor setting.

Research methods

A retrospective study was performed, collecting data from all consecutive patients who underwent colorectal operations using the FreeHand robot from September 20201 to April 2022. The data collected included: demographics, docking time, operating time, conversions, number and duration of intra-operative lens cleaning. All operating surgeons completed a survey that sought information on robot use.

Research results

There were 9 patients in this study who underwent: Right hemicolectomies (5), left hemicolectomy (1), sigmoid colectomies (2) and anterior resection (1). These operations were completed with a mean robot docking time of 6.33 min, mean duration of surgery of 122.33 min and mean estimated blood loss of 113.33 mL. The laparoscope was detached from the robot an average of 2.6 times per case, with cumulative mean interruption time of 4.2 min per case. The mean duration of hospitalization was 3.2 d and there were no complications recorded. Surgeons reported that there were good ergonomics, with no limitation on instrument movement, stable image and better control of surgical field.

Research conclusions

Robot-assisted laparoscopic colorectal surgery is feasible and safe in the resource-poor Caribbean setting, once there is appropriate training.

Research perspectives

Future research should incorporate large numbers of patients and a comparison of outcomes between robot-assisted and laparoscopic cases.