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<p>Robotic surgery has expanded minimally invasive options across several surgical specialties, yet adoption in peripheral vascular surgery remains limited. Groin incisions carry a high risk of wound infection with potentially devastating consequences. The da Vinci Single Port (SP) surgical system enables development of a subcutaneous space, relocating the incision away from the femoral region and potentially reducing wound complications. Earlier cadaveric studies identified arterial control and port placement as challenges for robotic femoral access. Additional iterative cadaveric sessions were undertaken to optimise these parameters. Each session assessed port positioning, exposure of femoral vessels, and feasibility of vascular reconstruction and arterial control. Initial medial mid-thigh port placement resulted in limited visualisation, extended dissection, or frequent robotic arm collision with the lower limb. Lateral repositioning to the ventral thigh improved visualization of the femoral triangle and eliminated external robotic arm interference. Centring the port 5 cm caudal to the femoral bifurcation on the ventral aspect of the thigh provided a reproducible anatomical landmark. Utilizing this configuration, robotic dissection of the arteries was consistently achieved, and vascular reconstruction was feasible. Arterial control strategies were evaluated, with percutaneous vascular clamping under robotic visualisation, slings with a vascular tourniquet, or endovascular control all being feasible techniques. Lateral ventral-thigh port placement avoids robotic arm collision with the patient and facilitates vascular reconstruction. Percutaneous clamping provides a practical strategy for arterial control with slings and endovascular approaches viable alternatives. These technical parameters provide a foundation for future clinical evaluation of robotic peripheral vascular surgery.</p>

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A proposed technique for robotic port placement and arterial control of the femoral region for a peripheral arterial bypass with the Da Vinci SP system

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月27日

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  • Philip Stather,
  • A. J. Williamson,
  • G. Stante,
  • L. Ryckembusch,
  • P. Bhandari,
  • A. Q. Howard

摘要

Robotic surgery has expanded minimally invasive options across several surgical specialties, yet adoption in peripheral vascular surgery remains limited. Groin incisions carry a high risk of wound infection with potentially devastating consequences. The da Vinci Single Port (SP) surgical system enables development of a subcutaneous space, relocating the incision away from the femoral region and potentially reducing wound complications. Earlier cadaveric studies identified arterial control and port placement as challenges for robotic femoral access. Additional iterative cadaveric sessions were undertaken to optimise these parameters. Each session assessed port positioning, exposure of femoral vessels, and feasibility of vascular reconstruction and arterial control. Initial medial mid-thigh port placement resulted in limited visualisation, extended dissection, or frequent robotic arm collision with the lower limb. Lateral repositioning to the ventral thigh improved visualization of the femoral triangle and eliminated external robotic arm interference. Centring the port 5 cm caudal to the femoral bifurcation on the ventral aspect of the thigh provided a reproducible anatomical landmark. Utilizing this configuration, robotic dissection of the arteries was consistently achieved, and vascular reconstruction was feasible. Arterial control strategies were evaluated, with percutaneous vascular clamping under robotic visualisation, slings with a vascular tourniquet, or endovascular control all being feasible techniques. Lateral ventral-thigh port placement avoids robotic arm collision with the patient and facilitates vascular reconstruction. Percutaneous clamping provides a practical strategy for arterial control with slings and endovascular approaches viable alternatives. These technical parameters provide a foundation for future clinical evaluation of robotic peripheral vascular surgery.