Preclinical evaluation of the newly developed carina platform in robotic-assisted proctectomy with porcine and cadaveric models.

Robotic-assisted laparoscopic surgery has made progress in addressing many of the technical challenges associated with conventional laparoscopy. Recently, a new robotic surgical system, Carina Platform, has been developed. The aim of this study is to evaluate the feasibility and safety of Carina for proctectomy surgery in preclinical models. Port and cart positions were initially determined by surgical simulation based on three-dimensional reconstruction. Six pigs, divided equally into acute and chronic groups, underwent robotic-assisted proctectomy using the Carina robotic system. Operative time, device errors and perioperative complications were recorded. All animals were observed postoperatively to assess their mental status, and after four weeks, the chronic pigs were euthanized for necropsy to evaluate the recovery of the anastomotic stoma. The optimal port and patient cart positions were further assessed in three human cadavers. Robotic-assisted proctectomy was successfully completed in all porcine subjects. No device-related intraoperative complications were observed. An autopsy examination revealed that the chronic pigs, which had been followed up for 28 days, had made a favorable recovery. The configurations of ports and patient carts were successfully validated in human cadaver models that could simulate the completion of a rectal resection. The feasibility and safety of the newly developed Carina robotic system for performing proctectomy were successfully demonstrated in porcine and cadaveric models. Further studies are required to validate its clinical application in human patients.