MR-guided HDR prostate brachytherapy with teleoperated steerable needles
AbstractConformity of tumour volumes and dose plans in prostate brachytherapy (BT) can be constrained by unwanted needle deflections, needle access restrictions and visualisation limitations. This work validates the feasibility of teleoperated robotic control of an active steerable needle using magnetic resonance (MR) for guidance. With this system, perturbations can be counteracted and critical structures can be circumvented to access currently inaccessible areas. The system comprises of (1) a novel steerable needle, (2) the minimally invasive robotics in an MR environment (MIRIAM) system, and (3) the daVinci Research Kit...
Source: Journal of Robotic Surgery - July 22, 2023 Category: Surgery Source Type: research
Trends in the surgical management of kidney cancer by tumor stage, treatment modality, facility type, and location
AbstractPartial nephrectomy (PN) is an alternative to radical nephrectomy (RN) in the appropriate localized renal tumor. The scope of PN has expanded over time and, since the advent and proliferation of minimally invasive surgery, more surgeons have access to and have been trained in laparoscopic and robotic technology. Amid the changing surgical landscape, we sought to characterize the trends in management by cancer stage, institution type, and geographic location using the National Cancer Database (NCDB). We queried the NCDB for patients with kidney cancer from 2004 to 2019. Overall, 241,311 patients who underwent PN or ...
Source: Journal of Robotic Surgery - July 20, 2023 Category: Surgery Source Type: research
Biochemical recurrence after chemohormonal therapy followed by robot-assisted radical prostatectomy in very-high-risk prostate cancer patients
In this study, patients were classified into three groups based on the National Comprehensive Cancer Network risk classification: low/intermediate-risk, high-risk, and very-high-risk groups. Patients with high- and very-high-risk PCa who were registered in the study received neoadjuvant chemohormonal therapy prior to RARP. Biochemical recurrence-free survival (BRFS) after RARP in patients with PCa was the primary endpoint of this study. The secondary endpoint was the relationship between biochemical recurrence (BCR) and clinical covariates. We enrolled 230 patients with PCa in our study, with a median follow-up of 17.0 m...
Source: Journal of Robotic Surgery - July 19, 2023 Category: Surgery Source Type: research
Perioperative outcomes of robot-assisted partial nephrectomy using hinotori versus da Vinci surgical robot system: a propensity score-matched analysis
In conclusion, these fi ndings showed that the hinotori platform could facilitate similar perioperative outcomes in patients undergoing RAPN in comparison with the existing robotic system, da Vinci. (Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - July 18, 2023 Category: Surgery Source Type: research
Establishment of a successful robotic pediatric general surgery practice
This study reports our institution ’s experience with RAS on a pediatric general surgery team. Following IRB approval, a retrospective review of all pediatric patients at our academic children’s hospital who underwent RAS between 2017 and 2022 for pediatric general surgical conditions was performed. Patient demographics, operatio n performed, operating time, complications, and recovery were evaluated. A total of 159 children underwent RAS, increasing from 10 patients in 2017 to 59 patients in 2022. The median age and weight were 15.3 years and 76.4 kg, and 121 (76.1%) were female. The application of RAS was successfu...
Source: Journal of Robotic Surgery - July 15, 2023 Category: Surgery Source Type: research
Experience matters for robotic assistance: an analysis of case data
AbstractMany robotic procedures require active participation by assistants. Most prior work on assistants ’ effect on outcomes has been limited in procedural focus and scope, with studies reporting differing results. Knowing how assistant experience affects operating room time could inform operating room case scheduling and provide an impetus for additional assistant training. As such, this retrospect ive cohort study aimed to determine the association between assistant experience and operating room time for 2291 robotic-assisted operations performed from 2016 to 2022 at our institution. Linear regression showed a signif...
Source: Journal of Robotic Surgery - July 14, 2023 Category: Surgery Source Type: research
Systematic review: robot-assisted versus conventional laparoscopic multiport cholecystectomy
AbstractLaparoscopic cholecystectomy has become the standard of care for the treatment of symptomatic gallstone disease. In the context of the increasing uptake of robotic surgery, robotic cholecystectomy has seen a substantial growth over the past decades. Despite this, a formal assessment of the evidence for this practice remains elusive and a randomised controlled trial is yet to be performed. This paper reviews the evidence to date for robotic multiport cholecystectomy compared to conventional multiport cholecystectomy. This systematic review was performed conducted using the Medline, Embase and Cochrane databases; in ...
Source: Journal of Robotic Surgery - July 13, 2023 Category: Surgery Source Type: research
Comments on ‘Robotic-assisted colectomy in children: a comparative study with laparoscopic surgery’
(Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - July 13, 2023 Category: Surgery Source Type: research
Procedure-specific risks of robotic simultaneous resection of colorectal cancer and synchronous liver metastases
This study, which is the largest national cohort of simultaneous CRC and CRLM resections, supports the safety and potential benefits of a robotic approach in these patients. (Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - July 12, 2023 Category: Surgery Source Type: research
Early perioperative outcomes of single-port compared to multi-port robot-assisted laparoscopic partial nephrectomy
AbstractSingle-port (SP) robot-assisted laparoscopic partial nephrectomy (RAPN) is a promising new technique. The aim of this study was to compare surgical and oncological outcomes of SP-RAPN to the multi-port (MP) surgical platform. This is a retrospective, cohort-based study involving patients undergoing SP-RAPN between 2019 and 2020 at a single institution. Demographic, preoperative, surgical, and postoperative outcomes data were gathered and compared to a 1-to-1 matched MP cohort. A total of 50 SP and 50 matched MP cases were included. Length of surgery and ischemia time were not statistically significant between the t...
Source: Journal of Robotic Surgery - July 11, 2023 Category: Surgery Source Type: research
Comparison of surgical outcomes between robot-assisted and conventional laparoscopic hysterectomy for large uterus
AbstractWe compared the effectiveness of conventional total laparoscopic hysterectomy (TLH) against robot-assisted total hysterectomy (RAH) in patients with a large uterus. According to the subtype of minimally invasive hysterectomy performed for benign indications, the patients (n = 843) were grouped as follows: TLH (n = 340) and RAH (n = 503). The median operative time (OT) for TLH was 98 min (47–406 min), and the estimated blood loss (EBL) was 50 mL (5–1800 mL). The median OT for RAH was 90 min (43–251 min), and the EBL was 5 mL (5–850 mL), with a significantly shorter OT and a lower EBL in ...
Source: Journal of Robotic Surgery - July 11, 2023 Category: Surgery Source Type: research
Robotic surgery in obstetrics and gynecology: a bibliometric study
In conclusion, robotic surgery research in obstetrics& gynecology is dominated by research in gynecologic oncology and reached a peak nearly a decade ago. The disparity in the quantity and quality of robotic research between high income countries and LMIC raises concerns regarding the access of the latter to high quality healthcare resources such as robotic surgery. (Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - July 10, 2023 Category: Surgery Source Type: research
A propensity score matched analysis of robotic and open hepatectomy for treatment of liver tumors. Clinical outcomes, oncological survival, and costs comparison
AbstractMinimally invasive robotic hepatectomy is gaining popularity with a faster rate of adoption when compared to laparoscopic approach. Technical advantages brought by the robotic surgical system facilitate a transition from open to minimally invasive technique in hepatic surgery. Published matched data examining the results of robotic hepatectomy using the open approach as a benchmark are still limited. We aimed to compare the clinical outcomes, survival, and costs between robotic and open hepatectomy undertaken in our tertiary hepatobiliary center. With IRB approval, we prospectively followed 285 consecutive patients...
Source: Journal of Robotic Surgery - July 10, 2023 Category: Surgery Source Type: research
Propensity-matched analysis of robotic versus sternotomy approaches for mitral valve replacement
AbstractTo compare early and medium-term outcomes between robotic and sternotomy approaches for mitral valve replacement (MVR). Clinical data of 1393 cases who underwent MVR between January 2014 and January 2023 were collected and stratified into robotic MVR (n = 186) and conventional sternotomy MVR (n = 1207) groups. The baseline data of the two groups of patients were corrected by the propensity score matching (PSM) method. After matching, the baseline characteristics were not significant different between the two groups (standardized mean diffe rence < 10%). Moreover, the rates of operative mortality (P...
Source: Journal of Robotic Surgery - July 9, 2023 Category: Surgery Source Type: research
Short learning curve in transition from laparoscopic to robotic-assisted rectal cancer surgery: a prospective study from a Finnish Tertiary Referral Centre
AbstractThe narrow pelvis causes special challenges in surgery, and robotic-assisted surgery has been proven beneficial in these circumstances. While robotic surgery has some specific advantages in rectal cancer surgery, there is still limited evidence of the learning curve of the technique involved. The aim here was to study the transition from laparoscopic to robotic-assisted surgery among experienced laparoscopic surgeons. The data for this study were collected from a prospectively compiled register that includes patients operated on by the Da Vinci Xi robot in Tampere University Hospital. Each consecutive rectal cancer...
Source: Journal of Robotic Surgery - July 8, 2023 Category: Surgery Source Type: research
