Technique of Laparoscopic Appendectomy Assisted by A Robotic Laparoscopic Positioner
Abstract
This paper describes a technique of laparoscopic appendectomy assisted by a robotic laparoscopic positioner called AESOP (Automated Endoscopic System for Optimal Positioning).
The three-trocar technique operates with a 10 mm-port at umbilicus, two 5 mm-ports at left and right suprapubic hairline and lateral to rectus muscles. The first port is made at umbilicus by semi-open technique. AESOP is fixed to the left upper part of the operating table and the 10 mm-laparoscope is positioned under surgeon's voice control. Two-hand technique conducts the operation by left-hand grasper and right-hand cauterized dissector, 5 mm-clip applier, ligature and scissors. The appendiceal stump is ligated by double chromic endoloops or single chromic endoloop with a purse string suture. Occasionally when needed, 10 mm GI-stapler (endoGIA®, EZ35®) is applied through the umbilical port. The 5 mm-laparoscope instead of 10 mm- laparoscope is then inserted through the left lower port. The specimen of the appendix is removed through the umbilical port.
Early experience in 20 cases showed no conversion rate and mortality. Only 2 cases of wound infection were encountered.
References
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