Navigated robot-guided pedicle screws placed successfully in single-position lateral lumbar interbody fusion
This study describes the pedicle screw placement of single-position lateral lumbar interbody fusion (SP-LLIF) cases in which navigated robotic assistance was used. A single-surgeon, single-site, retrospective Institutional Review Board-exempt review of the first 55 SP-LLIF navigated robot-assisted spine surgery cases performed by the lead author was conducted. An orthopaedic surgeon evaluated screw placement using plain film radiographs. In addition, pedicle screw malposition, reposition, and return to operating room (OR) rates were collected. In the first 55 SP-LLIF cases, 342 pedicle screws were placed. The average patie...
Source: Journal of Robotic Surgery - October 17, 2019 Category: Surgery Source Type: research

Hybrid abdominal robotic approach with conventional transanal total mesorectal excision (TaTME) for rectal cancer: feasibility and outcomes from a single institution
AbstractTotal mesorectal excision (TME) is currently recognised as the standard of care for patients with rectal cancer. Complete TME is known to be associated with lower rates of recurrence. Robotic and endoscopic TaTME approaches are reported to offer excellent proximal and distal rectal dissection into the TME plane, however, combining both approaches in a hybrid procedure could potentially optimise visualisation of the dissection plane and confer improved circumferential and distal margin rates. The aim of this study was to analyse the feasibility of a hybrid robotic abdominal approach with conventional TaTME for recta...
Source: Journal of Robotic Surgery - October 17, 2019 Category: Surgery Source Type: research

Robotic-assisted gastrectomy compared with open resection: a comparative study of clinical outcomes and cost-effectiveness analysis
The objective of the study is to compare the main operative and clinical outcomes and to assess the incremental cost-effectiveness ratios (ICERs) of the two techniques. This is a prospective cost-effectiveness and clinical study when comparing the robotic gastrectomy (RG) technique with open gastrectomy (OG) in gastric cancer. Outcome parameters included surgical and post-operative costs, quality-adjusted life years (QALY) and incremental cost per QALY gained or the incremental cost-effectiveness ratio (ICER). The incremental utility was 0.038 QALYs and the estimated ICER for patients was dominated by robotic approach. The...
Source: Journal of Robotic Surgery - October 16, 2019 Category: Surgery Source Type: research

Management of intractable bladder neck strictures following radical prostatectomy using the Memokath ® 045 stent
In conclusion, the Memokath®045 stent is a minimally invasive technique with faster recovery time compared to other techniques such as bladder neck reconstruction or urinary diversion. Additionally, it provides superior patency results compared to other techniques such as bladder neck incision and injection of Mitomycin C. Therefore, this management option should be considered in the management of VUAS. (Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - October 15, 2019 Category: Surgery Source Type: research

Robotic vs. open surgical management of ureteroenteric anastomotic strictures: technical modifications to enhance success
AbstractDevelopment of ureteroanastamotic strictures (UAS) after urinary diversion is not uncommon, but is challenging to treat. Poor outcomes are likely with endoscopic and radiologic management, and definitive surgical treatment can cause significant morbidity. The comparative advantages of an operative approach have not yet been fully described in the literature. We retrospectively reviewed the prospectively maintained Tulane University Department of Urology quality assurance database of 12 patients who underwent operative UAS repair between 2012 and 2018. Data were reviewed for operative approach, demographics, baselin...
Source: Journal of Robotic Surgery - October 4, 2019 Category: Surgery Source Type: research

Pathologic measures of quality compare favorably in patients undergoing robot-assisted radical cystectomy to open cystectomy cohorts: a National Cancer Database analysis
This study aims to assess the impact of facility characteristics on measures of surgical quality (positive surgical margin rates and lymph-node yield) in patients undergoing robot-assisted (RARC) versus open (ORC) radical cystectomy using the National Cancer Database. Patients who received RC between the years of 2010 –2013 were stratified according to surgery type (ORC vs. RARC), and corresponding patient and facility-level variables (facility type and volume) were assessed. Logistic regression models for procedure type, positive surgical margins (PSMs), and LN dissection (LND) rates were estimated. Radical cy stect...
Source: Journal of Robotic Surgery - October 3, 2019 Category: Surgery Source Type: research

Review of strategies and factors to maximize cost-effectiveness of robotic hysterectomies and myomectomies in benign gynecological disease
This article reviews application strategies and factors that can offset traditional costs and maximize the benefits of robotic surgery. (Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - September 28, 2019 Category: Surgery Source Type: research

Robotic resection of the uncinate process of the pancreas
AbstractSince the development of the robotic platform, the number of robotic-assisted surgeries has significantly increased. Robotic surgery has gained growing acceptance in recent years, expanding to pancreatic resection. Here, we report a total robotic resection of the uncinate process of the pancreas performed in a patient with a cystic neuroendocrine tumor. To our knowledge, this is the first report of a robotic resection of the uncinate process of the pancreas. A 46-year-old man with no specific medical history was diagnosed with a neuroendocrine tumor after undergoing routine imaging. Biopsy guided by echoendoscopy r...
Source: Journal of Robotic Surgery - September 28, 2019 Category: Surgery Source Type: research

Variation in the utilization of robotic surgical operations
AbstractThe appropriate use of the robot in surgery continues to evolve. Robotic operations (RO) are particularly advantageous for deep pelvic and retroperitoneal procedures, but the implementation of RO is unknown. We aimed to examine regional variation for the most commonly performed RO in general, gynecologic, and urologic surgery. A three-state inpatient database from 2008 to 2011 was used. Nine common robotic inpatient general, gynecologic and urologic surgery procedures were analyzed. States were divided into hospital service areas (HSAs). The percentage of RO was calculated for each operation. Hospital service areas...
Source: Journal of Robotic Surgery - September 27, 2019 Category: Surgery Source Type: research

Initial experience with extraperitoneal robotic-assisted simple prostatectomy using the da Vinci SP surgical system
AbstractRobotic-assisted simple prostatectomy (RASP) has emerged as a safe and effective treatment option for symptomatic patients with lower urinary tract symptoms related to significant benign prostatic enlargement (BPE) above 80  g. The recent release of the da Vinci SP robotic system (Intuitive, Sunnyvale, CA, USA) continues to advance the minimally invasive nature of robotic surgical technology. We now report our institution’s initial experience performing RASP using the da Vinci SP robotic system. An IRB-approved, ret rospective chart review was performed of all patients undergoing robotic-assisted simple ...
Source: Journal of Robotic Surgery - September 27, 2019 Category: Surgery Source Type: research

A multi-institutional analysis of 263 hilar tumors during robot-assisted partial nephrectomy
We present the characteristics and outcomes of 263 patients with hilar tumors undergoing robot-assisted partial nephrectomy (RPN) in the largest series to date. Perioperative, pathologic, functional, and oncological outcomes were compared between 1467 (84.8%) patients with a non-hilar tumor and 263 (15.2%) patients with a hilar tumor undergoing RPN. Variables were compared in univariable (unadjusted) analysis and using multivariable linear, logistic, poisson, cox proportional hazards and linear mixed effects regression models adjusting for tumor diameter and RENAL Nephrometry score. Hilar tumors were larger (3.7 vs. 3.0  cm,p 
Source: Journal of Robotic Surgery - September 26, 2019 Category: Surgery Source Type: research

The outcomes of two robotic platforms performing transanal minimally invasive surgery for rectal neoplasia: a case series of 21 patients
AbstractColorectal cancer remains the third most common cancer effecting adults. Surgical guidelines recommend transanal excision of early rectal neoplasia up to 8  cm from the anal verge. A retrospective review of two novel approaches for transanal robotic local excision with R0 resections of rectal cancers which was, on average, higher than 8 cm. Twenty-one cases of robotic assisted transanal surgery for early stage disease (T0–T1, N0) were reviewed. The first 10 cases performed with the da Vinci® Si robotic platform between 2013 and 2016, and the first 11 cases performed using the Flex® Medroboti...
Source: Journal of Robotic Surgery - September 25, 2019 Category: Surgery Source Type: research

Augmented reality for image guidance in transoral robotic surgery
AbstractWith the advent of precision surgery, there have been attempts to integrate imaging with robotic systems to guide sound oncologic surgical resections while preserving critical structures. In the confined space of transoral robotic surgery (TORS), this offers great potential given the proximity of structures. In this cadaveric experiment, we describe the use of a 3D virtual model displayed in the surgeon ’s console with the surgical field in view, to facilitate image-guided surgery at the oropharynx where there is significant soft tissue deformation. We also utilized the 3D model that was registered to the max...
Source: Journal of Robotic Surgery - September 25, 2019 Category: Surgery Source Type: research

Does the accuracy of pedicle screw placement differ between the attending surgeon and resident in navigated robotic-assisted minimally invasive spine surgery?
This study analyzes the accuracy of pedicle screw placement between an attending spine surgeon and a resident by comparing the left and right sides of the first 101 consecutive cases using navigated robotic assistance in a private practice clinical setting. A retrospective, Institutional Review Board-exempt review of the first 106 navigated robot-assisted spine surgery cases was performed. One attending spine surgeon and one resident performed pedicle screw placement consistently on either the left or right side (researchers were blinded). A CT-based Gertzbein and Robbins system (GRS) was used to classify pedicle screw acc...
Source: Journal of Robotic Surgery - September 21, 2019 Category: Surgery Source Type: research

Is there a role of robotic surgery in abdominal organs transplantations?
(Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - September 17, 2019 Category: Surgery Source Type: research

Learning curve for robotic surgery in children: a systematic review of outcomes and fellowship programs
AbstractThe learning curve (LC) of a new technique is fundamental for its application and assessment, and for the training. Literature was analysed to define the LCs of different surgical procedures and the impact of fellowship programs. MEDLINE, EMBASE and paediatric surgical journals ’ databases from January 1995 to December 2018 were systematically analysed. Two independent residents sought for articles providing description of robotic-assisted procedures’ LCs in paediatric age/population. Seventeen articles were selected, describing LC of robotic-assisted pyeloplasty (n = 9), fundoplication (n...
Source: Journal of Robotic Surgery - September 17, 2019 Category: Surgery Source Type: research

Two-year clinical outcomes associated with robotic-assisted subthalamic lead implantation in patients with Parkinson ’s disease
AbstractFew centers have routinely implemented robotic stereotactic systems for deep brain stimulator (DBS) placement. The  present study compares clinical outcomes associated with robotic-assisted subthalamic nucleus (STN)-targeted DBS surgery in patients with Parkinson’s disease (PD) to those of the traditional frame-based method. A retrospective chart review was performed (February 2013–June 2017). Thirty-three patients were implanted using the Cosman–Roberts–Wells (CRW) frame and 27 patients were implanted using the ROSA robot. Movement Disorder Society-Unified Parkinson’s Disease Rat...
Source: Journal of Robotic Surgery - September 13, 2019 Category: Surgery Source Type: research

Transition effects from laparocscopic to robotic surgery skills in small cavities
AbstractConventional laparoscopic surgery (LS) is being challenged by the ever-increasing use of robotic surgery (RS) to perform reconstructive procedures. The purpose of this study was to assess the acquisition of skills in both techniques and the potential transfer of skills from one technique to the other when restricted spaces are involved. A preclinical randomized crossover study design was implemented. Twelve subjects performed two different reproducible drill procedures: “Thread the Ring” (TR) and “Transfer the Plot” (TP). To assess surgical proficiency in confined workspaces, these exercises...
Source: Journal of Robotic Surgery - September 12, 2019 Category: Surgery Source Type: research

Surgical resection for diverticulitis using robotic natural orifice intracorporeal anastomosis and transrectal extraction approach: the NICE procedure
We present a pilot study to investigate the safety, feasibility and short-term outcomes of robotic Natural orifice-assisted IntraCorporeal anastomosis with transrectal Extraction of specimen, called the robotic NICE procedure. Consecutive patients presenting for elective resec tion for diverticulitis with formation of a colorectal anastomosis were entered into an IRB database. All patients underwent the robotic NICE procedure. Demographic data, intraoperative data and outcomes data were assessed and analyzed. Ten patients (five males and five females) underwent resection.  The mean age and BMI were 56 years (43&n...
Source: Journal of Robotic Surgery - September 10, 2019 Category: Surgery Source Type: research

Effects of lung protective ventilation on postoperative respiratory parameters in patients undergoing robot-assisted radical prostatectomy
AbstractTo investigate the effects of lung protective ventilation (LPV) compared to conventional ventilation (CV) on postoperative respiratory parameters in patients undergoing robot-assisted radical prostatectomy (RARP). In total, 24 patients undergoing RARP were randomized to two groups receiving either LPV with a tidal volume of 6  ml/IBW with a positive end-expiratory pressure (PEEP) of 10 cm H2O (intervention) or CV with a tidal volume of 10  ml/IBW with a PEEP of 4 cmH2O (control). Primary endpoint was PaO2 2  h postoperatively after 10 min of spontaneous respiration of atmospheric air. Force...
Source: Journal of Robotic Surgery - September 10, 2019 Category: Surgery Source Type: research

Society of Robotic Surgery Annual Meeting 2019, Orlando, FL, USA
(Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - September 6, 2019 Category: Surgery Source Type: research

Observational analysis of mesh related complications in urogynecologic procedures
The objective of this review is to analyze the incidence of the complications that arise after vaginal mesh surgeries with an insight to the American College of Obstetricians and Gynecologists recommendations on the management of those complications. (Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - September 6, 2019 Category: Surgery Source Type: research

Multivisceral robotic liver surgery: feasible and safe
AbstractThe application of robotic technology allows for the performance of multi-organ liver resections by multidisciplinary teams in a minimally invasive manner. Their technique and outcomes are not established. Herein we describe our technique with robotic liver surgery combined with colon, pancreas and urologic resections. Our patients are an 84-year-old (yo) female (Body Mass Index, BMI: 25) with a recently diagnosed right colon adenocarcinoma and two synchronous liver metastases at segments 5 and 6, a 75-year-old female (BMI: 50.4) with a history of right renal cell cancer status post (s/p) right robotic radical neph...
Source: Journal of Robotic Surgery - September 6, 2019 Category: Surgery Source Type: research

Robotic-assisted versus open pancreaticoduodenectomy: the results of a case-matched comparison
AbstractRobotic-assisted pancreaticoduodenectomy (RPD) is progressively gaining momentum. It seems to provide some potential advantages over open approach. Unfortunately, only few studies investigated the impact of RPD on the oncologic outcomes. We performed a 1:1 case-matched comparison between two groups of 35 patients affected by a malignant tumor who underwent RPD and open (OPD) pancreaticoduodenectomy from August 2014 to April 2016. Operative time was longer in the RPD group compared to OPD (355 vs 262  min,p = 0.023), whereas median blood loss (235 vs 575 ml,p = 0.016) and length...
Source: Journal of Robotic Surgery - August 31, 2019 Category: Surgery Source Type: research

Totally robotic right hemicolectomy: a multicentre case-matched technical and peri-operative comparison of port placements and da Vinci models
The objective of the study was to review the technical and peri-operative outcomes using the da Vinci Xi (dVXi) and da Vinci Si (dVSi) models with suprapubic port placement (SPPP) or traditional port placements (TPP) during a robotic right hemicolectomy (RRHC). A retrospective review was undertaken of prospectively maintained databases of RRHC performed by two senior colorectal surgeons in the USA and Australia. Data were prospectively collected for patient demographics, intra-operative technical outcomes and peri-operative clinical outcomes. A cohort of 138 patients underwent RRHC between 2013 and 2017: 134 (97%) had intr...
Source: Journal of Robotic Surgery - August 29, 2019 Category: Surgery Source Type: research

REBOA as a rescue strategy for catastrophic vascular injury during robotic surgery
AbstractCatastrophic bleeding is a feared complication of robotic abdominal procedures that involve dissection in close proximity to major vessels. In the event of uncontrollable hemorrhage, standard practice involves emergency undocking with conversion to laparotomy. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a rapid and life-saving technique gaining acceptance in the trauma setting for the management of catastrophic hemorrhage. The purpose of this study was to evaluate feasibility of REBOA for emergency hemostasis during robotic surgery. The surgical robot was docked to a REBOA mannequin to simu...
Source: Journal of Robotic Surgery - August 29, 2019 Category: Surgery Source Type: research

Value of robotic-assisted technique in redo gastrojejunostomy for severe stenosis after gastric bypass
AbstractDevelopment of gastrojejunal stricture following Roux-en-Y gastric bypass (RYGB) leads to an increase in morbidity and adverse effects, such as abdominal pain, vomiting, aspiration pneumonia, and malnutrition. Up to 38.5% of patients will require revisional surgery for late anastomotic strictures despite conservative treatment. However, no previous studies focused on revisional robotic bariatric surgery due to strictures after RYGB have been reported. To evaluate our outcomes and assess the advantages of the robotic platform with regard to laparoscopic and open revisional procedures. University Hospital. We perform...
Source: Journal of Robotic Surgery - August 29, 2019 Category: Surgery Source Type: research

Attitudes of robotic surgery educators and learners: challenges, advantages, tips and tricks of teaching and learning robotic surgery
AbstractAs the application of robotic surgical technology grows, so does the need to instruct surgical residents in robotic techniques. To better understand the challenges and benefits unique to robotic surgery education, this study explored the attitudes of teachers and learners. A 43-item questionnaire was developed with five domains: challenges and benefits of robotic education, training methodologies, trainees ’ readiness for learning, and education tips. This was delivered to surgeons and surgical fellows at a high-volume surgical department. 31 surgeons and 25 fellows from 7 specialties responded (response rate...
Source: Journal of Robotic Surgery - August 28, 2019 Category: Surgery Source Type: research

Robotic surgery does not affect upstaging of T1 renal masses
AbstractPartial nephrectomy is the mainstay of treatment for localized kidney cancer. A proportion of patients are upstaged post-operatively to locally advanced disease (pT3a). We aimed to identify the incidence of upstaging to pT3a during partial nephrectomy and its relationship to a robotic approach. The National Cancer Database was queried for patients diagnosed with cT1M0 disease between 2010 and 2015 who underwent an open or robotic partial nephrectomy with final stage pT1 –3a. Our primary outcome was rate of upstaging to pT3a in patients undergoing partial nephrectomy and secondary outcomes were stage migration...
Source: Journal of Robotic Surgery - August 27, 2019 Category: Surgery Source Type: research

Can we predict who will need lymphocele drainage following robot assisted laparoscopic prostatectomy (RALP)?
AbstractPelvic lymph node dissection (PLND) can cause lymphoceles. Lymphocele formation following PLND can reach up to 60% and are symptomatic in 0.4 to 16% of patients. The aim of the study was to identify factors that are significantly associated with lymphocele  drainage. We retrospectively analysed all men that underwent RALP between April 2010 and November 2018 from our prospectively collected IRB approved database. All patients who developed lymphoceles were grouped into two groups, the ones who were drained and those not drained. Chi-square test was used to perform univariate analysis for categorical varia...
Source: Journal of Robotic Surgery - August 17, 2019 Category: Surgery Source Type: research

Navigated robotic assistance results in improved screw accuracy and positive clinical outcomes: an evaluation of the first 54 cases
This study describes the cortical and pedicle screw accuracy for the first 54 cases where navigated robotic assistance was used in a surgical setting. This is a retrospective chart review of the initial 54 patients undergoing spine surgery with pedicle and cortical screws using robotic guidance with navigation. A computed tomography (CT)-based Gertzbein and Robbins System (GRS) was used to classify pedicle screw accuracy. Screw tip, tail, and angulation offsets were measured using image overlay analysis. Screw malposition, reposition, and return to operating room rates were collected. 1 of the first 54 cases was a revision...
Source: Journal of Robotic Surgery - August 8, 2019 Category: Surgery Source Type: research

The role of robotic-assisted surgery for the treatment of diverticular disease
(Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - August 3, 2019 Category: Surgery Source Type: research

Considerations regarding pain management and anesthesiological aspects in pediatric patients undergoing minimally invasive surgery: robotic vs laparoscopic –thoracoscopic approach
In conclusion, no significant change in the intensity of postoperative pain between the two groups was found, while it is seen that the pain in patients undergoing thoracic interventions (robotic/thoracoscopic) is more intense than that reported for other types of interventions. (Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - July 24, 2019 Category: Surgery Source Type: research

Perioperative outcomes after robotic versus vaginal surgery for pelvic organ prolapse
The objectives of the study were to compare post-anesthesia care unit opioid use and pain scores, surgical and hospitalization times, and perioperative adverse events rates following robotic sacrocolpopexy (RSC) versus transvaginal uterosacral ligament suspension (USLS). This was a retrospective analysis of women 18  years and older who underwent either robotic sacrocolpopexy (n = 87) or transvaginal uterosacral ligament suspension (n = 103) between January 1, 2015 to December 31, 2017 at Downey Medical Center by two surgeons. Data including nurses’ verbal pain scores and opioid use w...
Source: Journal of Robotic Surgery - July 22, 2019 Category: Surgery Source Type: research

Pedicle screw accuracy in clinical utilization of minimally invasive navigated robot-assisted spine surgery
This study describes the pedicle screw accuracy of the first 56 consecutive cases in which navigated robotic assistance was used in a private practice clinical setting. A retrospective, Institutional Review Board-exempt review of the first 56 navigated robot-assisted spine surgery cases was performed. Pedicle screw malposition, reposition, and return to operating room (OR) rates were collected. A CT-based Gertzbein and Robbins system (GRS) was used to classify pedicle screw accuracy. In the first 56 robotic cases, 356 total pedicle screws were placed. Eight screws were placed without the robot due to surgeon discretion. Of...
Source: Journal of Robotic Surgery - July 19, 2019 Category: Surgery Source Type: research

Outcomes and peri-operative complications of robotic pyelolithotomy
AbstractStandard of care for large or complex renal stones is percutaneous nephrolithotomy. Robotic pyelolithotomy, however, may be a feasible alternative, but limited data exist on its outcomes and complications. Our study objective was to describe the outcomes and peri-operative complications of robotic pyelolithotomy for complex renal calculi. We performed a retrospective analysis of robotic pyelolithotomy at our tertiary academic institution from 2015 to 2018. Demographics, stone clearance rates, complications, estimated blood loss, operative time, and length of stay were reported. 15 patients were included with a medi...
Source: Journal of Robotic Surgery - July 17, 2019 Category: Surgery Source Type: research

Robotic versus laparoscopic sphincter-saving total mesorectal excision for mid or low rectal cancer in male patients after neoadjuvant chemoradiation therapy: comparison of long-term outcomes
AbstractThe aim of our study was to compare long term outcomes of robotic and laparoscopic sphincter-saving total mesorectal excision (TME) in male patients with mid-low rectal cancer (RC) after neoadjuvant chemoradiotherapy (NCRT). The study was conducted as a retrospective review of a prospectively maintained database, and we analyzed 14 robotic and 65 laparoscopic sphincter-saving TME (R-TME and L-TME, respectively) performed by one surgeon between 2005 and 2013. Patient characteristics, perioperative recovery, postoperative complications and pathology results were compared between the two groups. The patient characteri...
Source: Journal of Robotic Surgery - July 16, 2019 Category: Surgery Source Type: research

Nationwide outcomes and costs of laparoscopic and robotic vs. open hepatectomy
AbstractThe safety of hepatectomy continues to improve and it holds a key role in the management of benign and malignant hepatic lesions. Laparoscopic and robotic approaches to hepatectomy are increasingly utilized. The purpose of this study was to compare outcomes and costs of laparoscopic and robotic vs. open approaches to hepatectomy and to determine the national nonelective postoperative readmission rate, including readmission to other hospitals. The Nationwide Readmission Database from 2013 to 2014 was queried for all patients undergoing hepatectomy. Patients undergoing laparoscopic and robotic hepatectomies were comp...
Source: Journal of Robotic Surgery - July 13, 2019 Category: Surgery Source Type: research

Robotic hepatic surgery in malignancy: review of the current literature
AbstractThe use of minimally invasive liver surgery, such as laparoscopic and robotic surgery, is increasing worldwide. Robot-assisted laparoscopy is a new surgical technique that improves surgical handling. The advantage of this technique is improved dexterity, which leads to increased surgical precision and no tremor or fatigue. Comparable oncological results were documented for laparoscopic and open surgery. Currently, “conventional” laparoscopic liver surgery has limitations with respect to the treatment of lesions in the posterior-superior segments, and there are limited technical features for the reconstr...
Source: Journal of Robotic Surgery - July 13, 2019 Category: Surgery Source Type: research

Robotic colectomy with intracorporeal anastomosis is feasible with no operative conversions during the learning curve for an experienced laparoscopic surgeon developing a robotics program
The objectives of the study were to compare the outcomes of robotic colectomy to laparoscopic colectomy for patients with right-sided tumors undergoing a standardized completely intracorporeal operation and to examine the impact of prior experience with laparoscopic right colectomies on the performance of robotic right colectomies. Retrospective review of outcomes of consecutive patients undergoing a robotic right colectomy (robot) compared to those undergoing laparoscopic colectomy (LAP). LAP patients were further subdivided into a group during the learning curve (LC) and after the learning curve (post-LC). Data collected...
Source: Journal of Robotic Surgery - July 13, 2019 Category: Surgery Source Type: research

Design methodology for a simulator of a robotic surgical system
AbstractTraditional spinal surgery procedures are completed with limited direct visualization. This imposes limitations on the surgeon ’s ability to place screws into the spine. The Mazor Renaissance robotic system was developed to improve the accuracy of pedicle screw insertion. Current training for this device comes with significant constraints. This suggests that a simulation-based solution may be valuable to the current train ing. This paper describes efforts to apply the theories of human–system integration (HSI) and instructional system design to define the requirements for a design of a simulator for spe...
Source: Journal of Robotic Surgery - July 13, 2019 Category: Surgery Source Type: research

Robotic harvesting of the omental flap: a case report and mini-review of the use of robots in reconstructive surgery
This study describes the robotic harvesting of a free omental flap. The patient was a 58-year-old man who had undergone several previous operations due to osteomyelitis caused by trauma. There was a non-healing wound and purulent discharge in the distal pretibial region. The flap was harvested based on the right gastroepiploic artery using robotic facilities only. The flap was then transferred to the debrided defect in the pretibial region. Anastomoses were performed between the posterior tibial vessels and the pedicle of the flap. A split thickness skin graft was used to cover the omental flap. The operation lasted 2.5 &n...
Source: Journal of Robotic Surgery - July 13, 2019 Category: Surgery Source Type: research

Ergonomic assessment of robotic general surgeons: a pilot study
AbstractInadequacies exist in the ergonomics of upper body positioning of robotic surgeons; these deficits in biomechanical efficacy predispose surgeons to musculoskeletal injury. Ergonomics and biomechanics may be objectively measured using the Rapid Entire Body Assessment (REBA) and the Rapid Upper Limb Assessment (RULA) to quantify ergonomic efficacy. The purpose of this study is to use validated ergonomic tools to assess the posture of robotic surgeons to examine deficiencies. Four robotic surgeons using the da Vinci model were observed for a minimum of 30  min each. An Xbox connect camera was positioned 10 f...
Source: Journal of Robotic Surgery - July 13, 2019 Category: Surgery Source Type: research

Robotic surgery using Senhance ® robotic platform: single center experience with first 100 cases
We present a prospective analysis of the first 100 robotic surgeries in abdominal surgery, gynecology, and urology in Klaipeda University Hospital, Klaipeda, Lithuania. Out of 100 operated patients during the mentioned period, 49 were female and 51 men, age range 27–79 years, on an average 55 years. 39 underwent robotic abdominal surgical procedures, 31—urological, and 30 gynecological surgeries. Duration of surgery varied from 30 min to 6 h and 5 min, on an average 2 h 25 min. Almost half 49 ( 49%) were operated on for malignant diseases: prostate cancer—27, renal cell carci...
Source: Journal of Robotic Surgery - July 12, 2019 Category: Surgery Source Type: research

Tensile force exerted by suture during renorrhaphy using current techniques
AbstractPartial nephrectomy has become the preferred treatment option for small renal masses. In particular, minimally invasive partial nephrectomy (MIPN) using laparoscopic or robotic approaches has shown decreased blood loss, shorter hospital stay, and faster return to normal activity compared to open surgery. However, MIPN still carries risk of postoperative complications including hemorrhage and urine leakage. Closure of the renal remnant, often called renorrhaphy, is a critical step to avoid these complications. The purpose of the study was to provide quantitative data on suture properties during partial nephrectomy. ...
Source: Journal of Robotic Surgery - July 12, 2019 Category: Surgery Source Type: research

Advantages of using a robotic stapler in rectal cancer surgery
AbstractTo compare short-term postoperative outcomes in patients undergoing robotic total mesorectal excision (TME) after the use of robotic and laparoscopic staplers. Over a 5-year period, 196 patients were divided into 2 groups according to the use of laparoscopic (LS) or robotic stapler (RS). Patient demographics and postoperative complications were compared. A total of 145 (74%) robotic TME were performed using the LS and 51 (26%) the RS. No conversions to laparoscopy or laparotomy were observed, in either group. Transection of the rectum using one or two firings was achieved in a higher proportion of RS cases (91%) co...
Source: Journal of Robotic Surgery - July 9, 2019 Category: Surgery Source Type: research

Visualization of peri-prostatic neurovascular fibers before and after radical prostatectomy by means of diffusion tensor imaging (DTI) with clinical correlations: preliminary report
AbstractTo evaluate if diffusion tensor imaging (DTI) is able to detect morphological changes of peri-prostatic neurovascular fibers (PNF) before and after robot-assisted radical prostatectomy (RARP) and if these changes are related to urinary incontinence (UI) and erectile dysfunction (ED). From October 2014 and August 2017, 26 patients with biopsy-proven prostate cancer underwent prostatic multiparametric magnetic resonance imaging (mp-MRI) including DTI sequencing before, and 6 months after, RARP. Images were analyzed by placing six regions of interest (ROI), respectively, at base, mid gland, and apex, one for each side...
Source: Journal of Robotic Surgery - July 6, 2019 Category: Surgery Source Type: research

Is secondary robotic pyeloplasty safe and effective as primary robotic pyeloplasty? A systematic review and meta-analysis
AbstractRobot-assisted laparoscopic pyeloplasty (RLP) has excellent surgical safety and efficacy in primary pyeloplasty. In recent, the application of robotics has explored to more complex surgical conditions such as failed pyeloplasty. This meta-analysis aimed to evaluate the surgical and clinical outcomes of secondary RLP compared with primary RLP. Following PRISMA guidelines, we carried out an extensive literature search in the PubMed, Web of Science, Cochrane Library, Scopus, and Google Scholar to extract the published articles comparing primary vs. secondary RLP up to April 2019. Interested surgical and clinical outco...
Source: Journal of Robotic Surgery - July 6, 2019 Category: Surgery Source Type: research

Robotic-assisted adrenalectomy using da Vinci Xi vs. Si: are there differences?
This study shows that outcomes were similar between Xi and Si groups. (Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - July 4, 2019 Category: Surgery Source Type: research

Prospective randomized controlled trial comparing cephalad migration in robotic gynecologic surgery using egg-crate foam versus the Pink Pad ®
The objectives of the study were to compare the cephalad migration of two patient positioning pads used in robotic gynecologic surgery and to determine if any correlation exists between cephalad movement and time in Trendelenburg position or body mass index. This was a prospective randomized controlled open-label trial (Canadian Task Force classification I). Sixty women undergoing robotic-assisted laparoscopic gynecologic surgery were randomized to the Pink Pad® system or egg-crate foam pre-operatively. Patients were placed under general anesthesia and then positioned in dorsal lithotomy. The locations of the iliac cre...
Source: Journal of Robotic Surgery - June 29, 2019 Category: Surgery Source Type: research