Design and utilisation of a novel, high-fidelity, low-cost, hybrid-tissue simulation model to facilitate training in robot-assisted partial nephrectomy
AbstractRobot-assisted partial nephrectomy (RAPN) has rapidly evolved as the standard of care for appropriately selected renal tumours, offering key patient benefits over radical nephrectomy or open surgical approaches. Accordingly, RAPN is a key competency that urology trainees wishing to treat kidney cancer must master. Training in robotic surgery is subject to numerous challenges, and simulation has been established as valuable step in the robotic learning curve. However, simulation models are often both expensive and suboptimal in fidelity. This means that the number of practice repetitions for a trainee may limited by...
Source: Journal of Robotic Surgery - March 1, 2024 Category: Surgery Source Type: research
Microfracture-coagulation for the real robotic liver parenchymal transection
AbstractThe use of the robotic approach in liver surgery is exponentially increasing. Although technically the robot introduces several innovative features, the instruments linked with the traditional laparoscopic approach for the liver parenchymal transection are not available, which may result in multiple technical variants that may bias the comparative analysis between the different series worldwide. A real robotic approach, minimally efficient for the liver parenchymal transection, with no requirement of external tool, available for the already existing platforms, and applicable to any type of liver resection, counting...
Source: Journal of Robotic Surgery - February 29, 2024 Category: Surgery Source Type: research
Perception of robotic-assisted surgery (RAS) among medical students: a systematic review and meta-analysis
DiscussionMedical students from developed nations display favorable attitudes towards RAS. However, implementing of revised curriculum at the beginning of the graduation level sparks medical students' attitude towards robotic surgery. (Source: Journal of Robotic Surgery)
Source: Journal of Robotic Surgery - February 28, 2024 Category: Surgery Source Type: research
The learning curve of robot-assisted laparoscopic pyeloplasty in children
AbstractTo explore the learning curve of robot-assisted laparoscopic pyeloplasty (RALP) in children. The clinical data, surgical information, and postoperative complications of consecutive cases of RALP performed by the same surgeon in Shanghai Children's Hospital from January 2014 to July 2020 were retrospectively analyzed; the surgeon is a senior pediatric urologists who is proficient in laparoscopic pyeloplasty; the data consist of console time (CT), suture method when anastomosing ureteropelvic junction (UPJ), number of stitches (N), anastomosis time per stitch (tn), the average suture time per stitch (T) = (sutur...
Source: Journal of Robotic Surgery - February 28, 2024 Category: Surgery Source Type: research
Postoperative outcomes of transperitoneal versus retroperitoneal robotic partial nephrectomy: a propensity-score matched comparison focused on patient mobilization, return to bowel function, and pain
AbstractLiterature meta-analyses comparing transperitoneal versus retroperitoneal approach to robotic partial nephrectomy (RPN) suggested some advantages favoring retroperitoneoscopy. Unfortunately, patient-centered data about mobilization, canalization, pain, and use of painkillers remained anecdotally reported. The present analysis aimed to compare transperitoneal versus retroperitoneal RPN focusing on such outcomes. Study data including baseline variables, perioperative, and postoperative outcomes of interest were retrieved from prospectively maintained institutional database (Jan 2018 –May 2023) and compared between ...
Source: Journal of Robotic Surgery - February 28, 2024 Category: Surgery Source Type: research
The stress for surgeons: exploring stress entities with the robotic senhance surgical system
AbstractRobotic surgery is on its way to revolutionizing traditional surgical procedures, offering precise and minimally invasive techniques hypothesized to shorten recovery times and improve patient outcomes. While there have been multiple publications on robotic systems ’ medical and procedural achievements, more emphasis should be put on the surgeon’s experience, especially in comparison with laparoscopic surgery. The present report aims to systematically examine the stress impact on surgeons by comparing the robotic Senhance Surgical System (Asensus Surgical, Durham, North Carolina, U.S.A) to laparoscopic surgery. ...
Source: Journal of Robotic Surgery - February 28, 2024 Category: Surgery Source Type: research
Systematic review comparing uretero-enteric stricture rates between open cystectomy with ileal conduit, robotic cystectomy with extra-corporeal ileal conduit and robotic cystectomy with intra corporeal ileal conduit formation
AbstractCystectomy is the gold standard treatment for muscle invasive bladder cancer. Robotic cystectomy has become increasingly popular owing to quicker post- operative recovery, less blood loss and less post-operative pain. Urinary diversion is increasingly being performed with an intracorporeal technique. Uretero-enteric strictures (UES) cause significant morbidity for patients. UES for open cystectomy is 3 –10%, but the range is much wider (0–25%) for robotic surgery. We aim to perform systematic review for studies comparing all 3 techniques, to assess for ureteric stricture rates. A systematic review was conducted...
Source: Journal of Robotic Surgery - February 28, 2024 Category: Surgery Source Type: research
Modeling and experimental analysis of wire-driven continuum surgical robot
AbstractA new configuration of continuum surgical robot is proposed, whose skeleton is composed of inner and outer layers. The outer layer is composed of miniature rotating modules connected in series and connected by orthogonal hinges, which can ensure the ability to resist unconventional torsion without losing the degree of freedom. The inner layer is a central support column with superelasticity. When bending, its superelasticity can make the overall configuration biased toward constant curvature bending, which is convenient for motion control and according to the new configuration, this paper establishes the kinematics...
Source: Journal of Robotic Surgery - February 28, 2024 Category: Surgery Source Type: research
A narrative review of the Medtronic Hugo RAS and technical comparison with the Intuitive da Vinci robotic surgical system
AbstractMedtronic launched the Hugo Robotic-Assisted Surgery (RAS) System in 2021, offering a modular alternative to the incumbent market leader in surgical robotics, the Intuitive da Vinci (dV) surgical system. A detailed technical review of the Hugo RAS was conducted to explore the strengths and weaknesses of this new robotic surgical system. Each component of the system —vision tower, arm cart, and surgeon console—was compared against the existing dV systems. The docking process, instrumentation, and external arm movement trajectories were analyzed. The modular Hugo RAS provides the possibility of operating using up...
Source: Journal of Robotic Surgery - February 28, 2024 Category: Surgery Source Type: research
Feasibility of robotic cholecystectomy at an academic center with a young robotic surgery program: a retrospective cohort study with umbrella review
This study introduces a single-surgeon experience with laparoscopic versus robotic cholecystectomy and an umbrella systematic review of the outcomes of both approaches. A retrospective chart review was performed at a single institution on a prospectively maintained database of patients undergoing laparoscopic or robotic cholecystectomy for benign gallbladder pathology. An umbrella systematic review was conducted using PRISMA methodology. A total of 103 patients were identified; 61 patients underwent LC and 42 underwent RC. In the RC cohort, 17 cases were completed using a four-port technique while 25 were completed using a...
Source: Journal of Robotic Surgery - February 27, 2024 Category: Surgery Source Type: research
Safety and learning curve analysis of robotic-assisted pancreaticoduodenectomy: experience of a single surgeon
This study analyzed the clinical outcomes of 85 consecutive RPD cases performed by a single surgeon to evaluate the safety and learning curve of RPD using the da Vinci Xi robotic system. There were 51 male and 34 female patients, with a median age of 64 (20 –87) years. The average preoperative body weight and BMI were 64.15 ± 11.43 kg and 23.36 ± 3.33 kg/m2, respectively. The clinical outcomes of each patient were analyzed using the textbook outcome(TO), and the learning curve of the RPD was evaluated by calculating the TO rate of patients using the cumulative sum analysis method (CUSUM).The operation time (O...
Source: Journal of Robotic Surgery - February 24, 2024 Category: Surgery Source Type: research
Biochemical implications of robotic surgery: a new frontier in the operating room
AbstractRobotic surgery represents a milestone in surgical procedures, offering advantages such as less invasive methods, elimination of tremors, scaled motion, and 3D visualization. This in-depth analysis explores the complex biochemical effects of robotic methods. The use of pneumoperitoneum and steep Trendelenburg positioning can decrease pulmonary compliance and splanchnic perfusion while increasing hypercarbia. However, robotic surgery reduces surgical stress and inflammation by minimizing tissue trauma. This contributes to faster recovery but may limit immune function. Robotic procedures also limit ischemia –reperf...
Source: Journal of Robotic Surgery - February 24, 2024 Category: Surgery Source Type: research
Outcomes of discoid excision and segmental resection for colorectal endometriosis: robotic versus conventional laparoscopy
AbstractSurgery for deep endometriosis with colorectal involvement is an option after medical treatment failure. Over the past decade, robotic laparoscopy has emerged as an alternative to conventional laparoscopy. We aimed to evaluate surgical outcomes of robotic versus conventional laparoscopy for discoid excision and segmental resection. From 2019 to 2023, we conducted a retrospective cohort study of 152 consecutive patients with colorectal endometriosis who underwent robotic or conventional laparoscopy for discoid excision and colorectal resection. Ninety of the patients 152 underwent robotic surgery and 62 conventional...
Source: Journal of Robotic Surgery - February 22, 2024 Category: Surgery Source Type: research
Analysis of robot-specific operative time and surgical team anxiety level and its effect on alignment during robot-assisted TKA
AbstractAdapting to robotic-assisted (RA) total knee arthroplasty (TKA) is hindered by the surgeon's fear of extra time. The main purpose of this study was to determine the robot's operative time, and the secondary goals were to assess the surgical team's anxiety, implant location and size, and limb alignment. From February to April 2022, 40 participants participated in prospective research. The study included primary Cuvis joint active RA-TKA patients for end-stage arthritis, but conversion of unicompartmental knee arthroplasty to TKA, and patients with prior knee surgery were excluded. The active RA-TKA surgical time inc...
Source: Journal of Robotic Surgery - February 22, 2024 Category: Surgery Source Type: research
Robotic surgery: public perceptions and current misconceptions
AbstractWhilst surgeons and robotic companies are key stakeholders involved in the adoption of robotic assisted surgery (RS), the public’s role is overlooked. However, given that patients hold ultimate power over their healthcare decisions, public acceptance of RS is crucial. Therefore, this study aims to identify public understanding, opinions, and misconceptions about RS. An online questionnair e distributed between February and May 2021 ascertained the views of UK adults on RS. The themes of questions included familiarity, experience and comfort with RS, opinions on its ethical implications, and the impact of factua...
Source: Journal of Robotic Surgery - February 22, 2024 Category: Surgery Source Type: research
