Short-term outcomes and the learning curve for laparoscopic right hemicolectomy using the ArtiSential: a multicenter pooled analysis

Background: Minimally invasive surgery for colorectal cancer has demonstrated significant advantages over traditional methods, but laparoscopic procedures remain technically challenging. ArtiSential is an articulated handheld laparoscopic system designed to offer greater maneuverability similar to robotic surgery, while addressing cost constraints. However, its clinical efficacy in right hemicolectomy (RHC) for right-sided colon cancer remains underexplored. Methods: A multicenter, retrospective study was conducted from January 2021 to October 2022, enrolling 511 patients who underwent laparoscopic RHC for right-sided colon cancer. Of these, 167 patients underwent ArtiSential-assisted RHC, while 344 underwent conventional RHC. Propensity-score matching (PSM) was used to balance baseline variables. Additionally, we employed cumulative sum analysis to evaluate the learning curve associated with ArtiSential use. Results: After PSM, each group consisted of 165 patients, with no significant differences in baseline clinical characteristics. The median operation time was 148 min for both procedures (p = 0.423). No significant differences were observed in complication rates, including intraoperative blood loss, open conversion, postoperative ileus, anastomotic leakage, or wound complications between ArtiSential-assisted RHC and conventional RHC. Moreover, the total expenses were not different between the groups. Cumulative sum analysis indicated that surgeons reached proficiency with ArtiSential after an average of 19 cases. Conclusion: ArtiSential-assisted RHC proves to be a safe and feasible option, yielding comparable outcomes to conventional RHC with no significant differences in intraoperative or postoperative metrics. Surgeons can achieve proficiency with ArtiSential after performing an average of 19 cases. These findings suggest that ArtiSential could be a valuable addition to the minimally invasive surgical toolkit for right-sided colon cancer treatment.