Single-site robotic, endometrial cancer staging surgery using additional laparoscopic multi-articulating instrument, Artisential

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. As robotic surgery is becoming more common, surgical tools regarding robotic surgery is also developing at a fast rate. Initially, robotic surgery was performed using multi-port; however, with gaining popularity with single-port surgery, single-port robot was developed. Therefore, the field of single-port robot surgery is expanding and the number of cases are increasing. In single site robotic surgery, the size of incision limits the number of equipment that may simultaneously enter the operation field to one camera and two robot arms. Therefore, in cases where an additional laparoscopic instrument is needed, another incision has to be made. This video contains single site robotic surgery using a multi-articulating instrument performed on two patients. The first case is a single-site robotic surgery using a multi-robot system and the second case is a single-port robotic surgery using single-port robot system. In both patients, total hysterectomy and both salpingo-oophorectomy were performed. Additional sentinel lymph node dissection was done in the single-site surgical case (first case) and pelvic lymph node dissection in singleport surgical case (second case). Artisential was used for both cases. The Artisential allowed multiple degrees of movement and therefore more complex techniques were able to be performed compared to rigid or straight instruments. In surgeries that would previously have required an additional incision, we were able to successfully complete the single-site or single-port robotic endometrial cancer staging using the Artisential.