{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:40:52Z","timestamp":1785552052900,"version":"3.56.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006390","name":"University of Lausanne","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006390","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>The key benefits of robotics are improved precision and control, thanks to fully articulated robotic instruments and enhanced, stable endoscope control. However, colorectal procedures also require large movements such as medialization of the colon where a robotic platform is not always needed. We present the world\u2019s first experience in colorectal surgery with a new open platform of on-demand robotics.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods and procedures<\/jats:title>\n                <jats:p>Standard laparoscopic 3-D camera, insufflator, trocars and energy devices, available in all hospitals performing laparoscopic surgery, are used in combination with the Dexter System\u2122 from Distalmotion SA, which includes two robotic instrument arms, one robotic endoscope arm and a sterile surgeon console. We present the first 12 colorectal cases of robotic assisted ventral mesh rectopexy (<jats:italic>n<\/jats:italic>\u2009=\u20092), oncologic right colectomies (<jats:italic>n<\/jats:italic>\u2009=\u20098), transverse colectomy (<jats:italic>n<\/jats:italic>\u2009=\u20091) and ileocecal resection (<jats:italic>n<\/jats:italic>\u2009=\u20091) using the Dexter System.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The two ventral mesh rectopexies were fully robotic, requiring no switching from standard laparoscopy to robotic assistance. The robotic platform was used for central vascular ligation (CVL) in all 8 oncologic colectomies, whereas medialization of the colon and transection was performed with standard laparoscopy. The switch from laparoscopy to robotics and back was performed in 15\u201330\u00a0s. Intracorporal anastomosis was performed in 4 patients (stapling by standard laparoscopy and suturing of the defect with robotic assistance). Conversion or permanent switch to standard laparoscopy was required in two patients due to visceral obesity. No robotic platform-related intraoperative adverse event occurred. No major morbidity occurred at 60\u00a0days.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>On-demand robotics is feasible and combines the best of two worlds: Robotics where precision and enhanced dexterity are required and standard laparoscopy where it is at its best. The surgeon remains scrubbed-in at all times, allowing a switch between robotics and laparoscopy within seconds.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00464-023-10284-7","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T20:31:43Z","timestamp":1690230703000},"page":"8594-8600","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Feasibility of on-demand robotics in colorectal surgery: first cases"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5595-4114","authenticated-orcid":false,"given":"Dieter","family":"Hahnloser","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djana","family":"Rrupa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Grass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,24]]},"reference":[{"issue":"1","key":"10284_CR1","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1007\/s13304-020-00862-y","volume":"73","author":"MA Abd El Aziz","year":"2021","unstructured":"Abd El Aziz MA, Grass F, Behm KT, Shawki S, D\u2019Angelo AL, Mathis KL et al (2021) Trends of complications and innovative techniques\u2019 utilization for colectomies in the United States. Updates Surg 73(1):101\u201310","journal-title":"Updates Surg"},{"issue":"1","key":"10284_CR2","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1001\/jamasurg.2019.4083","volume":"155","author":"KH Sheetz","year":"2020","unstructured":"Sheetz KH, Norton EC, Dimick JB, Regenbogen SE (2020) Perioperative outcomes and trends in the use of robotic colectomy for medicare beneficiaries from 2010 through 2016. JAMA Surg 155(1):41\u201349","journal-title":"JAMA Surg"},{"issue":"9","key":"10284_CR3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057516","volume":"12","author":"S Hinrichs-Krapels","year":"2022","unstructured":"Hinrichs-Krapels S, Ditewig B, Boulding H, Chalkidou A, Erskine J, Shokraneh F (2022) Purchasing high-cost medical devices and equipment in hospitals: a systematic review. BMJ Open 12(9):e057516","journal-title":"BMJ Open"},{"issue":"16","key":"10284_CR4","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1001\/jama.2017.7219","volume":"318","author":"D Jayne","year":"2017","unstructured":"Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J et al (2017) Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA 318(16):1569\u20131580","journal-title":"JAMA"},{"key":"10284_CR5","doi-asserted-by":"publisher","first-page":"e1218","DOI":"10.1097\/SLA.0000000000003805","volume":"274","author":"J Crippa","year":"2020","unstructured":"Crippa J, Grass F, Dozois EJ, Mathis KL, Merchea A, Colibaseanu DT et al (2020) Robotic surgery for rectal cancer provides advantageous outcomes over laparoscopic approach: results from a large retrospective cohort. Ann Surg 274:e1218","journal-title":"Ann Surg"},{"key":"10284_CR6","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1016\/S2468-1253(22)00248-5","volume":"7","author":"Q Feng","year":"2022","unstructured":"Feng Q, Yuan W, Li T, Tang B, Jia B, Zhou Y et al (2022) Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial. Lancet Gastroenterol Hepatol 7:991","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"10284_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.02.004","author":"D Bohlen","year":"2023","unstructured":"Bohlen D, Gerber R (2023) First ever radical prostatectomy performed with the new dexter robotic system. Eur Urol. https:\/\/doi.org\/10.1016\/j.eururo.2023.02.004","journal-title":"Eur Urol"},{"key":"10284_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.05.034","author":"D Thillou","year":"2023","unstructured":"Thillou D, Robin H, Ricolleau C, Benali NA, Forgues A, Emeriau D et al (2023) Robot-assisted radical prostatectomy with the dexter robotic system: initial experience and insights into on-demand robotics. Eur Urol. https:\/\/doi.org\/10.1016\/j.eururo.2023.05.034","journal-title":"Eur Urol"},{"issue":"8","key":"10284_CR9","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1007\/s11605-012-1909-3","volume":"16","author":"M Hubner","year":"2012","unstructured":"Hubner M, Larson DW, Wolff BG (2012) \u201cHow I do it\u201d\u2013radical right colectomy with side-to-side stapled ileo-colonic anastomosis. 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Int J Colorectal Dis 32(5):675\u2013681","journal-title":"Int J Colorectal Dis"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-023-10284-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-023-10284-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-023-10284-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T16:09:37Z","timestamp":1704730177000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-023-10284-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,24]]},"references-count":10,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10284"],"URL":"https:\/\/doi.org\/10.1007\/s00464-023-10284-7","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,24]]},"assertion":[{"value":"5 April 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 July 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dieter Hahnloser and Fabian Grass are consultants for Distalmotion. Djana Rrupa has no disclosures. Dieter Hahnloser, Djana Rrupa, Fabian Grass have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}