Evaluating the feasibility of robotic-assisted abdominal aortic replacement in a porcine model.

This study aimed to evaluate the technical feasibility and procedural safety of robotic-assisted abdominal aortic replacement (RAAAR) using a porcine model, with the goal of supporting the future clinical translation of robotic aortic surgery. Eight healthy adult pigs underwent total robotic-assisted abdominal aortic replacement using the domestic MedBot® robotic system (KD-SR-2000 and JinFeng platforms). Perioperative monitoring included heart rate, central venous pressure, mean arterial pressure, oxygen saturation, and core temperature. Surgical parameters such as operative time, blood loss, and tissue integrity were also assessed. All eight procedures were completed successfully without conversion to open or laparoscopic surgery. The median operative time was 129 min (IQR: 122–132), with dissection, exposure, and cross-clamping times of 41 min (IQR: 39–43), 34.2 min (IQR: 32–35), and 68 min (IQR: 66–72), respectively. Anastomosis times for the anterior and posterior aortic walls were 10.5 min (IQR: 9–11) and 15 min (IQR: 14–16), with no leaks observed. The median number of stitches was 27 (IQR: 26–28), and time per stitch was less than 90 s. Estimated blood loss was 59.5 mL (IQR: 48–63), and bleeding after clamp release was 20 mL (IQR: 15–22). Vital signs remained stable intraoperatively, and postmortem examination revealed no bleeding, leakage, or organ injury. RAAAR demonstrated technical feasibility and procedural safety in a large animal model. These findings provide experimental support for the future clinical application of robotic-assisted aortic surgery in human AAA treatment.