Carina up for the LAR challenge - Italian MIS expert sings high praise

On April 27th-28th, 2023, renowned Italian minimally invasive surgeon Prof. Luigi Boni from University of Milan visited Ronovo Surgical to conduct hands-on evaluations of the Carina RAS Platform over two days of animal and cadaver labs, focusing on the challenging procedure of low anterior resections (LARs).

Commenting on the overall performance of Carina, he remarked, "I was really surprised, actually. Everything today was my first time with your system, and I had no issues whatsoever. The overall experience was very good."

The first day focused on live animal models, and Prof. Boni used Carina to perform LARs with iliac vessel lymph node dissections, known to be one of the most challenging minimally invasive procedures. Requiring surgeons to meticulously dissect and remove lymph nodes closely adhering to the walls of arteries and veins, the procedure demands a high level of stability and precision from the robotic surgical arm. Prof. Boni used Carina to complete precise dissection of the tissues surrounding the vessels, complete exposure of bilateral internal and external iliac vessels, and lymph node dissection in one smooth sequence.

The second day focused on LAR in a cadaver model. Known to be one of the most extensive abdominal procedures in general surgery, LARs require the mesentery to be dissected from the splenic flexure of the colon down to the sigmoid colon, followed by a complete resection of the entire rectal mesentery. The surgical area encompasses the entire left abdomen and pelvis. This procedure places high demands on the robotic system's multi-quadrant operating capability and the flexibility of surgical instruments, making it a challenging aspect of robot-assisted surgery.

Here, the modular architecture of Carina demonstrated its strengths as Prof. Boni operated Carina with a single surgical position and one time docking, to successfully complete LAR without significant arm collisions. During the operation, he was able to first perform the mesentery dissection accurately from the splenic flexure down to the sigmoid colon. He then followed the standard TME principles to free the rectal mesentery, simulate resection of rectal lesions, and finally perform intestinal anastomosis through manual suturing using the robot's dexterous wristed instruments.

In addition to instrument performance, Prof. Boni was pleasantly surprised by the high definition of the 3D display that provided clear visualization of tissues. He particularly commended the energy platform, which met all his requirements during the LAR surgery. Comparing the performance and operational experience of Carina with similar surgical robotics systems overseas, Prof. Boni concluded the unique advantages of Carina makes the system well-positioned for future entry into international markets.

Contact
ZiHan Lin
VP of Business Development
zihan.lin@ronovosurgical.com