Is it Beneficial to Utilize an Articulating Instrument in Single-Port Laparoscopic Gastrectomy?

Purpose: As the number of gastric cancer survivors is increasing and their quality of life after surgery is being emphasized, single-port surgery is emerging as an alternative to conventional gastrectomy. A novel multi-degree-of-freedom (DOF) articulating device, the ArtiSential (R) device (LivsMed, Seongnam, Korea), was designed to allow more intuitive and meticulous control for surgeons facing ergonomic difficulties with conventional tools. In this study, we evaluated the feasibility of this new device during single-port laparoscopic distal gastrectomy (SP-LDG) for early gastric cancer (EGC) patients. Materials and Methods: Consecutive patients diagnosed with EGC who underwent SP-LDG with ArtiSential (R) (LivsMed) graspers between April 2018 and August 2020 were enrolled in the study. The clinical outcomes were compared with those of a control group, in which prebent graspers (Olympus Medical Systems Corp) were used for the same procedures. Results: Seventeen patients were enrolled in the ArtiSential (R) group. There was no significant difference in operative time (205.4 +/- 6.0 vs. 218.1 +/- 9.9 minutes, P=0.270) or the quality of surgery, in terms of the number of retrieved lymph nodes (49.5 +/- 3.5 vs. 45.9 +/- 4.0, P=0.473), length of hospital stay (15.4 +/- 2.0 vs. 12.4 +/- 1.3 days, P=0.588), and postoperative complications (40.0% vs. 41.2%, P=0.595), between the ArtiSential (R) group and the control group. Conclusions: The new multi-DOF articulating grasper is feasible and can be used as an alternative for prebent graspers during SP-LDG.