The Use of a Robotic Stapling Device for Coincidental Appendectomy

Background: Coincidental appendectomy has been shown to be beneficial in numerous patient populations. Previous reports have noted that laparoscopic surgical staplers used at the time of gynecologic surgery allow for simple, rapid removal of the appendix with decreased procedure time and no spillage of appendiceal contents into the peritoneal cavity. The use of a robotic stapler will provide the same benefits and eliminate the need for the surgeon to rely on conventional laparoscopy to complete the appendectomy. Materials and Methods: The robotic stapling device is a reusable, wristed stapling instrument that delivers six rows of staples with transection down the middle of the staple lines. This stapler was used to complete coincidental appendectomies, using the same surgical technique, in 10 patients undergoing primary gynecologic surgery. The surgical and pathologic outcomes were evaluated. Results: All appendectomies were successfully performed by the console surgeon without assistance. There were no intraoperative or postoperative complications identified and no conversions to any other surgical method to complete the procedure. Pathology was identified in five (50%) appendix specimens. Conclusions: The robotic stapler can be used by the console surgeon alone to perform coincidental appendectomy. Larger series of patients will be needed to evaluate safety, efficiency, and incidence of abnormal pathology. (J GYNECOL SURG 31:148)