Robotic transperitoneal versus retroperitoneal approach for anterior renal mass nephron-sparing surgery
AbstractRobotic nephron-sparing surgery is traditionally performed via a transperitoneal (TP) approach. However, the retroperitoneal (RP) approach has gained popularity, particularly for posterolateral renal masses. The RP approach is associated with shorter operative time, less blood loss, and shorter length of stay, while preserving oncologic outcomes in selected masses. Here, we aim to assess the feasibility of the RP approach in excising anterior renal masses. Patients ≥ 18 years of age who underwent robotic nephron-sparing surgery for anterior renal masses were retrospectively identified (2008–2022). Baselin...
Source: Journal of Robotic Surgery - February 14, 2024 Category: Surgery Source Type: research
The weight of BMI in impacting postoperative and oncologic outcomes in pancreaticoduodenectomy is attenuated by a robotic approach
This study was undertaken to observe the effect of body mass index (BMI) on perioperative outcomes and survival when comparing robotic vs ‘open’ pancreaticoduodenectomy. With IRB approval, we prospectively followed 505 consecutive patients who underwent either robotic or ‘open’ pancreaticoduodenectomy from 2012 to 2021. For illustrative purposes, patients were separated based on the Center for Disease Control and Prevention BM I table but regression analysis was utilized to identify significant relationships involving BMI. Data are presented as median (mean ± SD). Significance was determined atp ≤ 0.05. ...
Source: Journal of Robotic Surgery - February 14, 2024 Category: Surgery Source Type: research
Partial nephrectomy series using Versius robotic surgical system: technique and outcomes of an initial experience
We presented our setting, surgical technique and outcomes for PN, using VRSS. Between 2022 and 2023, 15 patients underwent PN performed by two surgeons in two different centers. Fifteen patients underwent PN. The median lesion size identified on preoperative imaging was 4 (IQR 2.3 –5) cm. Median PADUA score was 8 (IQR 7–9). Two procedures were converted to radical nephrectomy for enhanced oncological disease control. Of the 13 nephrectomies that were completed as partial, 7 were performed clampless and 6 with warm ischemia clamping. Median clamping time was 10 (IQR 9–11 ) minutes. No procedure was converted to open. ...
Source: Journal of Robotic Surgery - February 13, 2024 Category: Surgery Source Type: research
Review of robotic surgery platforms and end effectors
AbstractIn the last 50 years, the number of companies producing automated devices for surgical operations has grown extensively. The population started to be more confident about the technology capabilities. The first patents related to surgical robotics are expiring and this knowledge is becoming a common base for the development of future surgical robotics. The review describes some of the most popular companies manufacturing surgical robots. The list of the company does not pretend to be exhaustive but wishes to give an overview of the sector. Due to space constraints, only a limited selction of companies is r eporte...
Source: Journal of Robotic Surgery - February 13, 2024 Category: Surgery Source Type: research
Minimally invasive sacrocolpopexy: efficiency of robotic assistance compared to standard laparoscopy
AbstractMinimally invasive abdominal sacrocolpopexy (SC) is the treatment of choice for symptomatic, high-grade, apical or multi-compartmental pelvic organ prolapse (POP), in terms of anatomical correction and treatment durability. Robot-assisted sacrocolpopexy (RASC) could be an attractive alternative to the gold standard laparoscopic sacrocolpopexy (LSC), for its ergonomic advantages in such a technically demanding procedure. However, it has not yet proven its superiority, consequently raising cost-effectiveness issues. Our primary objective was to assess if RASC can achieve better overall operative time (OOT) over LSC, ...
Source: Journal of Robotic Surgery - February 10, 2024 Category: Surgery Source Type: research
Design and evaluation of a smart passive dynamic arm support for robotic-assisted laparoscopic surgery
The objective is to present a novel design and prototype of a dynamic arm support for robotic laparoscopic surgery to evaluate its ergonomics and performance on the AdLap-VR simulation training device. The prototype was designed using the mechanical engineering design process: Technical requirements, concept creation, concept selection, 3D-design and built of the prototype. A crossover study was performed on a marble sorting task on the AdLap-VR. The first group performed four trials without the arm support, followed by four trials with the arm support, and the other group executed the sequence vice versa. The performance ...
Source: Journal of Robotic Surgery - February 10, 2024 Category: Surgery Source Type: research
Two- and three-dimensional evaluations following handheld robot-assisted total knee arthroplasty
This study aimed to evaluate and compare the alignment of the components using two- and three-dimensional (2D and 3D) measurements following handheld imageless robot-assisted TKA. Seventy consecutive patients underwent primary TKA at our institution using a handheld robot-assisted system. Full ‐length standing anteroposterior and lateral radiographs were obtained 2 weeks after surgery for assessment of 2D component alignments. Pre- and postoperative computed tomography (CT) images were obtained to assess 3D component alignment. The reference points defined on preoperative CT images wer e transferred to the postoperative...
Source: Journal of Robotic Surgery - February 10, 2024 Category: Surgery Source Type: research
Comparative analysis of robotic and laparoscopic surgery for mid and low rectal cancer in patients with varied body mass indexes: evaluating of short-term outcomes
AbstractThe main aim of this study was to evaluate and contrast the efficacy of robotic and laparoscopic surgical procedures in the treatment of low and mid rectal cancer in different BMI (body mass index) groups. The clinical records of patients who had laparoscopic or robotic proctectomy at a single center between December 2019 and August 2023 were analyzed. Then we utilized a classification framework to categorize individuals based on their BMI into three unique groups: non-obese, overweight, and obese. The short-term efficacy was evaluated. A consecutive sample of 1413 patients was included in this retrospective invest...
Source: Journal of Robotic Surgery - February 8, 2024 Category: Surgery Source Type: research
Risk of pseudoaneurysm and bleeding complications after partial nephrectomy: comparison of tumor enucleation to standard margin technique
AbstractPartial nephrectomy (PN) is the gold standard for the resection of amenable small renal masses. Some surgeons have adopted tumor enucleation (TE) over the standard margin PN (SPN) technique based on preservation of healthy renal parenchyma by following the tumor pseudocapsule. However, TE may also confer additional advantages due to avoidance of sharp incision including reduction in perioperative and bleeding complications. Therefore, we evaluated the rate of pseudoaneurysms and other complications following TE vs. SPN. A retrospective cohort study of patients undergoing PN (TE and SPN) between 2008 and 2020 was co...
Source: Journal of Robotic Surgery - February 8, 2024 Category: Surgery Source Type: research
The rise of robotic colorectal surgery: better for patients and better for surgeons
AbstractRobotic colorectal surgery represents a major technological advancement in the treatment of patients with colorectal disease. Several recent randomized controlled trials comparing robotic colorectal surgery with laparoscopic surgery have demonstrated improved short-term patient outcomes in the robotic group. Whilst the primary focus of research in robotic surgery has been on patient outcomes, the robotic platform also provides unparalleled benefits for the surgeon, including improved ergonomics and surgeon comfort, with the potential to reduce occupational injuries and prolong career longevity. It is becoming clear...
Source: Journal of Robotic Surgery - February 8, 2024 Category: Surgery Source Type: research
Assessment of the quality of online patient-oriented information on robotic colorectal surgery
This study sets out to analyze websites that provide patient-centered information on robotic colorectal surgery. Three search engines (Google, Yahoo and Firefox) were used with search terms ‘robotic colorectal surgery’ and the first 20 results on each platform assessed. After screening sites using predetermined criteria, further analysis was performed with the DISCERN questionnaire and Cohen Kappa analysis. Out of the 60 websites identified from the initial search, only 14 websites contained patient information on robotic colorectal surgery. Of these, only three (21%) sites had been updated in the past year and one sit...
Source: Journal of Robotic Surgery - February 8, 2024 Category: Surgery Source Type: research
Assessing intraoperative pedicle screw placement accuracy using biplanar radiographs compared to three-dimensional imaging
AbstractTo date, biplanar imaging (2D) has been the method of choice for pedicle screw (PS) positioning and verified for the anteroposterior view and (spinal midline) M-line method. In recent years, the use of intraoperative three-dimensional (3D) imaging has become available with the Gertzbein –Robbins system (GRS) to assess PS breach and positioning confirmation. The aim is to determine if 2D imaging is sufficient to assess PS position in comparison to advanced 3D imaging.Retrospective review of prospectively collected data from 204 consecutive adult patients who underwent posterior thoracic and lumbar instrumented fus...
Source: Journal of Robotic Surgery - February 8, 2024 Category: Surgery Source Type: research
Retzius-sparing vs. posterior urethral suspension: similar early-phase post-robotic radical prostatectomy continence outcomes
AbstractStress urinary incontinence (SUI) is a risk of robotic-assisted radical prostatectomy (RP) which can be a frustrating problem for both surgeons and patients. We aim to compare short-term continence outcomes between patients undergoing Retzius Sparing RP (RS-RP) and those undergoing standard RP with the inclusion of a PUS suture technique and suprapubic tube (PUS-RP). A retrospective review of 105 consecutive patients who underwent RP was performed, comparing patients who underwent RS-RP and PUS-RP. Our main outcome was pad usage as a surrogate for SUI. Patients were evaluated 4 weeks following RP and again at appro...
Source: Journal of Robotic Surgery - February 5, 2024 Category: Surgery Source Type: research
Incisional hernias following robotic-assisted laparoscopic prostatectomy: does the extraction site matter?
AbstractThe incidence of incisional hernia (IH) following robotic-assisted laparoscopic prostatectomy (RALP) varies widely within the literature (0.4 –9.7%). Whilst small hernias may go unnoticed, the potential exists for bowel strangulation and subsequent emergency surgery. We suggest that the extraction site may influence the rate of IH. A retrospective chart review of a single surgeon RALP series was undertaken. One hundred charts were sampl ed, of which 69 had sufficient data to be analysed. Prior to July 2017, specimen extraction had been via the supra-umbilical port site. After this time, specimens were extracted v...
Source: Journal of Robotic Surgery - February 3, 2024 Category: Surgery Source Type: research
The downtrending cost of robotic bariatric surgery: a cost analysis of 47,788 bariatric patients
AbstractThe surgical robot is assumed to be a fixed, indirect cost. We hypothesized rising volume of robotic bariatric procedures would decrease cost per patient over time. Patients who underwent elective, initial gastric bypass (GB) or sleeve gastrectomy (SG) for morbid obesity were selected from Florida Agency for Health Care Administration database from 2017 to 2021. Inflation-adjusted cost per patient was collected. Cost-over-time ($/patient year) and change in cost-over-time were calculated for open, laparoscopic, and robotic cases. Linear regression on cost generated predictive parameters. Density plots utilizing a...
Source: Journal of Robotic Surgery - February 3, 2024 Category: Surgery Source Type: research
