Figure 1

Illustration of the operating theatre set-up with iKnife/REIMS instrumentation and surgical robotic system. (a) Simplified intraoperative set-up of the first in human-robotic iKnife cases. The da Vinci Si robotic system (Intuitive Surgical, CA, USA) was used including the surgeon’s operating console. The iKnife system was equipped with a REIMS interface where analysis of surgical aerosol occurred. The surgical aerosol was collected from the working surgical environment and transferred to the iKnife instrument using a 3 mm internal diameter polytetrafluoroethylene (PTFE) aspiration tube. (b) Close-up illustration of the robotic arms and the iKnife aspiration tube during the TORS cases. For tissue ablation, a 2 µm thulium laser fibre (RevoLix, CA, US) was used. (c) Close-up illustration of the robotic arms and the iKnife aspiration tube during the transaxillary parathyroidectomy case. For tissue cutting and coagulation, the Harmonic Ace Curved Dissector (Ethicon Endo-surgery, part of Johnson and Johnson, OH, US) was used.