Bowel injury in robotic gynecologic surgery: risk factors and management options. A systematic review

Picerno, T.; Sloan, Nancy L.; Escobar, Pedro F.; Ramírez, Pedro T.

doi:10.1016/j.ajog.2016.08.040

Cited by 22 publications

(23 citation statements)

References 143 publications

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“…Inexperienced assistants can easily damage bowel tissue or tear organs as they attempt to orient their instruments appropriately. Undetected bowel injury may occur in 0.01-0.08% of laparoscopic procedures, and can have dramatic effects on the post-operative course [24][25][26]. ELV improved the mean time to stop simulated bleeding, and most participants indicated that they would use the device in the operating room.…”

Section: Discussionmentioning

confidence: 97%

Enhanced Laparoscopic Vision Improves Detection of Intraoperative Adverse Events During Laparoscopy

Trilling

Vijayan

Goupil

et al. 2022

IRBM

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Background: The absence of visibility of the entire surgical scene in laparoscopic surgery can lead to unforeseen intraoperative complications. An Enhanced Laparoscopy Vision System (ELViS) was developed to eliminate the blind spots of the traditional endoscope by providing a broad view of the surgical scene from a distance, thanks to two additional images. This study assessed whether the broad view provided by the Enhanced Laparoscopic Vision (ELV) helped the surgeon to detect and react to an unexpected intraoperative adverse event (simulated hemorrhage) occurring while performing a standard task.Methods: While participants were performing a standard task (sorting pins) on a dry lab laparoscopic simulator with or without ELV, a simulated bleeding (LED lighting) was randomly triggered. Perprocedure metrics were recorded and surgeons' feedback gathered at the end of the session.Results: Thirteen Senior surgeons participated. Mean response time was significantly reduced when using ELV, with a similar number of simulated bleeding events between both modalities. All surgeons agreed that ELV could be helpful and constitutes an acceptable increase in cognitive load. Conclusion:In a dry lab setup, compared to traditional endoscopy, the broader field of view provided by ELV improved outcomes when dealing with unforeseen complications like bleeding.

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Section: Discussionmentioning

confidence: 97%

Enhanced Laparoscopic Vision Improves Detection of Intraoperative Adverse Events During Laparoscopy

Trilling

Vijayan

Goupil

et al. 2022

IRBM

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“…Whether it reduces bowel injuries needs to be further investigated. 39 Three-Dimensional (3D) laparoscopic gynecological surgery was developed to provide the surgeon with a monitor image that closely resembles actual anatomy. This improves the speed and accuracy of laparoscopic phantom tasks and offers an advantage in teaching laparoscopic skills.…”

Section: Future Perspectivesmentioning

confidence: 99%

Bowel injury following gynecological laparoscopic surgery

Elbiss¹,

Abu‐Zidan²

2018

Afr H. Sci.

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BackgroundBowel injury remains a serious complication of gynecological laparoscopic surgery. We aimed to review the literature on this topic, combined with personal experiences, so as to give recommendations on how to avoid and manage this complication.MethodsWe performed a narrative review on bowel injury following gynecological laparoscopic surgery using PubMed covering prevention, diagnosis, and management. Search terms used were laparoscopy, gynaecology, injury, bowel, prevention, treatment.ResultsImportant principles of prevention include proper pre-operative evaluation and increased laparoscopic surgical skills and knowledge. High clinical suspicion is crucial for early diagnosis. Diagnostic workup of suspected cases includes serial abdominal examination, measuring inflammatory markers, and performing imaging studies including abdominal ultrasound and CT scan. When bowel injury is recognized during the first laparoscopic procedure then laparoscopic primary suturing could be tried although laparotomy may be needed. When diagnosis is delayed, then laparotomy is the treatment of choice. The role of robotic surgery and three-dimensional laparoscopic gynecological surgery on bowel injury needs to be further assessed.ConclusionEarly recognition of bowel injury is crucial for a favorable clinical outcome. A combined collaboration between gynecologists and general surgeons is important for timely and proper decisions to be made.

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“…Good surgical technique with good exposure and correct use of electric energy are important to prevent injuries. The majority of bowel injuries are recognized intra-operatively (87%) and repaired by minimally invasive approach (58%) [79]. Nerve injuries can occur due to poor patient positioning but also during lymph node dissection (genitofemoral nerve, obturator nerve) and parametrial dissection (para-sympathetic plexus) during radical hysterectomy.…”

Section: Surgical Complicationsmentioning

confidence: 99%

Robotic Hysterectomy for Cancer and Benign Pathology

Kohut¹,

Goldberg²,

Meritens³

2018

New Horizons in Laparoscopic Surgery

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The da Vinci Surgical System is an innovative technology that has advanced the laparoscopic treatment of benign and malignant diseases in gynecology. In this chapter, we will discuss the da Vinci Surgical System technology, including its history, utilization, surgical technique for benign and oncologic hysterectomy, future directions and surgical complications. Through a review of the literature, we aim to chronicle the current trends of application in both benign and oncologic gynecologic conditions and describe the current standards of care in this innovative and evolving operative technology. Although the future utility of robotic surgeries and robotic hysterectomies necessitates further research, the potential application of this surgical method affords great promise.

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Bowel injury in robotic gynecologic surgery: risk factors and management options. A systematic review

Cited by 22 publications

References 143 publications

Enhanced Laparoscopic Vision Improves Detection of Intraoperative Adverse Events During Laparoscopy

Enhanced Laparoscopic Vision Improves Detection of Intraoperative Adverse Events During Laparoscopy

Bowel injury following gynecological laparoscopic surgery

Robotic Hysterectomy for Cancer and Benign Pathology

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