Robot-assisted laparoscopic surgery using the ANSUR surgical unit, which acts as first assistant and scopist controlled by the operating surgeon
Target Population
Patients with gastrointestinal diseases including sigmoid colon cancer, suitable for minimally invasive surgery
Care Setting
Operating room equipped for laparoscopic and robot-assisted surgery
Key Highlights
ANSUR surgical system is a compact, mobile surgical robot that replaces the first assistant and scopist during laparoscopic surgery.
Robot-assisted laparoscopic sigmoid resection using ANSUR was successfully performed on a 69-year-old woman with stage IIIB sigmoid colon adenocarcinoma.
ANSUR allows manipulation of laparoscopic instruments via sensors and foot switch without a surgeon console, enhancing surgical efficiency and reducing reliance on human assistance.
Guideline-Based Recommendations
Diagnosis
Confirm diagnosis of sigmoid colon cancer by colonoscopy and histology.
Perform staging including assessment of tumor invasion and lymph node involvement.
Management
Plan robot-assisted laparoscopic sigmoid resection using the ANSUR surgical system for suitable patients.
Use standard trocar placement and laparoscopic instruments with attached sensors for robotic manipulation.
Perform medial to lateral mesenteric dissection preserving critical structures such as ureter and gonadal vessels.
Transect rectum using a linear stapler and extract specimen through umbilical wound.
Monitoring & Follow-up
Monitor intraoperative positioning and docking of the ANSUR system to maintain optimal surgical field exposure.
Observe for adhesion and manage accordingly during abdominal entry.
Ensure proper function and responsiveness of surgical instrument and trocar sensors throughout the procedure.
Risks
Potential for adhesion-related complications during trocar insertion.
Risk of injury to ureter and gonadal vessels if not carefully preserved during mesenteric dissection.
Technical challenges related to robotic system manipulation requiring surgeon training and certification.
Patient & Prescribing Data
Patients with sigmoid colon cancer eligible for minimally invasive surgery
Robot-assisted laparoscopic surgery with ANSUR can be performed without additional trocars compared to conventional laparoscopy, potentially improving surgical efficiency and surgeon well-being.
Clinical Best Practices
Ensure surgeon is trained and certified in robotic surgery and familiar with ANSUR system operation.
Maintain standard trocar placement consistent with conventional laparoscopic sigmoid resection.
Use sensor-equipped laparoscopic instruments and trocars to control robotic arms effectively.
Position patient appropriately (head and right side lowered by 15°) to optimize surgical field exposure.
Preserve critical anatomical structures such as ureter and gonadal vessels during mesenteric dissection.
Perform careful docking and alignment of the ANSUR system parallel to the operating table.
