Handheld, powered surgical tools combine advantages of traditional laparoscopy, robotics

Editor's Note

Combining dexterity and cost-effectiveness, handheld robotic devices offer potential to bridge the gap between traditional laparoscopy and more expensive robotic platforms, researchers concluded August 8 in the journal Surgery.

The mini-review of clinical trials covered clinical applications of three handheld robotic devices:

• the HandX powered laparoscopic instrument from HumanXtensions
• an articulating needle holder from FlexDex Surgical
• ArtiSential handpieces available with several end effectors (forceps, needle holders, and so forth).

All have been tested in various general surgical procedures, including hernia repair, gastric bypass, and colorectal surgery.

The findings suggest that handheld robotic devices are noninferior to conventional laparoscopic instruments in terms of operative time and postoperative complications. No cases required conversion to open surgery or traditional laparoscopy. Notably, the HandX device demonstrated comparable operative times to robotic surgery in certain hernia repairs, while costing significantly less per case. FlexDex Surgical showed promising results in complex procedures like Roux-en-Y gastric bypass. ArtiSential, the most widely studied of the three, was used in a variety of colorectal procedures with no major complications and a potential for shorter hospital stays.

Despite these promising results, the review acknowledges these devices are still in their early stages of development, and further data are needed to fully understand their impact. The potential for handheld robotic devices to enhance surgical precision while reducing costs could make them a valuable tool in minimally invasive surgery, particularly in settings where full robotic platforms are financially prohibitive.