Early Experience with Telemanipulative Abdominal and Cardiac Surgery with the Zeus™ Robotic System Erste Erfahrungen mit dem Operationsroboter Zeus™ bei abdominal- und herzchirurgischen Eingriffen

Summary: Background: In the past 15 years, abdominal and thoracic surgery has been greatly changed by the introduction of minimally invasive techniques; these offer great advantages for the patient but pose problems for surgeons. Disadvantages due to the limited movement radius of the endoscopic instruments and the rigidity of the instrument tips can be reduced or eliminated by the use of computer-assisted telemanipulators.Methods: We report our experience with eight abdominal and seven heart operations performed between 16 March and 31 July 2001 with a Zeus™ surgical robotic system. There were four cholecystectomies, four Nissen fundoplications, five atraumatic dissections of the left internal mammary artery (ITA), and two pericardotomies.Results: All but one operation were completed successfully with the Zeus™ device. No patient suffered any peri- or postoperative complications. Due to an electronic defect in one of the manipulators, the final cholecystectomy had to be completed as a conventional laparoscopic procedure. The duration of surgery was about 40 % longer than with conventional laparoscopic technique. The specific costs related to the robotic system were EUR 910 per operation.Conclusions: Computer-assisted manipulators are at a developmental stage that allows their successful use in clinical applications. Routine use is, however, at present only possible with a limited number of procedures.