Feasibility of articulating laparoscopic instrument in laparoscopic adnexectomy: a multinational prospective observational study.

Objective: The purpose of this study is to evaluate the feasibility of laparoscopic adnexa surgery using the articulating laparoscopic instrument, which offers flexible and ergonomic movements similar to robotic systems. Methods: This multicenter prospective observational study was conducted in South Korea and Taiwan. The electronic medical records of patients who underwent laparoscopic adnexectomy using the articulating laparoscopic instrument (ArtiSential®; LIVSMED Inc.) between October 2022 and September 2023 were analyzed. Data on patient demographics, operative and pathologic data were prospectively collected. Results: A total of 66 patients underwent laparoscopic adnexal surgery using the articulating instrument. The median age of the patients was 43 years (range, 23-76), and the median body mass index was 22.5 kg/m2 (range, 17.1-43.4). Of the patients, 35 (53.0%) underwent oophorectomy or salpingectomy, 31 (47.0%) underwent cystectomy of the ovary or fallopian tube. The final pathology after surgery was benign in 61 patients (92.4%), followed by borderline in 3 patients (4.5%) and malignant in 2 patients (3.0%). During surgery, pelvic adhesion was present in 13 patients (19.7%) and adhesiolysis was performed. The median total operation time was 53.5 minutes (range, 26 - 174), and the median estimated blood loss was 50 mL (range, 10-200). The median length of postoperative hospital stay was 1 days (range, 0-3 days). Only two patients experienced a postoperative complication, which was a trocar site wound dehiscence. Conclusion: The results of this study demonstrate the feasibility of using the articulating laparoscopic instrument during laparoscopic adnexectomy. [ABSTRACT FROM AUTHOR]