Solo surgeon ambulatory magnetic-assisted robotic surgery (MARS): initial 51 cases with high patient satisfaction

Abstract

BACKGROUND: Magnetic-assisted robotic surgery (MARS) is a new platform developed to maximize the benefits of minimally invasive surgery for patients while enhancing surgeon control and visualization. The system is composed of two robotic arms that enable surgeon control of the laparoscopic camera and a deployable intraperitoneal magnetic grasper designed to provide incisionless retraction. The aim of this study was to evaluate the outcomes of the MARS platform following its use in outpatient laparoscopic cholecystectomy by a solo surgeon and examine patient perceptions of this approach. METHODS: A retrospective review of a prospectively maintained database identified all patients who underwent outpatient reduced port laparoscopic cholecystectomy assisted by MARS for symptomatic cholelithiasis from January 2024 to August 2024 at a tertiary care hospital. All cholecystectomies were performed without a surgical assistant. Primary outcomes were 30-day morbidity, 30-day readmission, operative time, and 30-day patient satisfaction as measured by a modified version of the Surgical Satisfaction Questionnaire (SSQ). RESULTS: Fifty-one patients were identified. Mean age was 47.3 ± 13.9 years and most patients were female (N = 45, 88.2%). Mean operative time was 52.8 ± 16.3 min. All patients were discharged within 6 h after surgery. There were no 30-day morbidities or readmissions. Forty patients (78.4%) completed the modified SSQ at 30 days postoperatively and reported high degrees of satisfaction with pain management, return to preoperative baseline function, and the overall surgical experience. 92.5% of patients were "very satisfied" with the use of the MARS system and 97.5% would recommend use of the system to others. CONCLUSION: This study demonstrates the safety and feasibility of the MARS platform for use in outpatient reduced port laparoscopic cholecystectomy by a solo surgeon with high patient satisfaction. MARS was particularly useful for simultaneous gallbladder retraction and laparoscopic camera manipulation by the operating surgeon, thus eliminating the need for a surgical assistant.