The following is a summary of “Clinical Experience of a Smart Articulating Digital Device for Transanal Minimally Invasive Surgery,” published in the December 2023 issue of Gastroenterology by Khan, et al.

Because transanal minimally invasive surgery has limited access, doctors use robotic-assisted platforms to make up for their limited movement and maybe even their lack of skills.HandX is a powered, 5-mm, lightweight, and portable laparoendoscopic electromechanical digital device made by HumanXtensions in Israel. It has hardware and software parts that precisely translate surgical hand movements to the instrument’s articulating tip. It allows robotic transanal minimally invasive surgery with full tip reticulation for hook diathermy and suturing.

HandX was used in three transanal minimally invasive surgeries after training on a bench and a biological model. The patients were two men and one woman, with a mean age of 66.3 years. The largest of the rectal tumors was 30 mm on average, and they were situated 3 cm from the anal edge, 2 of them behind the urethra and 1 on the other side. Standard transanal minimally invasive surgery equipment and setup (Gelport Path, Applied Medical with Airseal, and Conmed) were used. The HandX device was added for marking lesion edges and performing full-thickness resection with hemostatic glue and flaw suturing as needed. Even though one patient had annoying hemorrhoidal bleeding, all treatments were finished quickly (less than an hour). 

Two of the masses were T1 cancers, and one was a tubulovillous adenoma with high-grade dysplasia. All of them were completely removed. All of the patients were sent home within 48 hours of surgery, though one had a secondary bleed on day 5 after surgery.HandX skillfully enabled endoscopic robot-like instruments to move during transanal minimally invasive surgery without stopping work. With time spent learning how to use the instruments and getting trained, HandX improved skills in a small operating room and may be more cost-effective than other platforms.

Source: journals.lww.com/dcrjournal/abstract/2023/12000/clinical_experience_of_a_smart_articulating.23.aspx