Comparison of the operative outcomes and learning curves between laparoscopic and “Micro Hand S” robot-assisted total mesorectal excision for rectal cancer: a retrospective study

Wang, Yanlei; Wang, Guohui; Li, Zheng; Hao, Ling; Yi, Bo; Zhu, Shaihong

doi:10.1186/s12876-021-01834-1

Cited by 4 publications

(19 citation statements)

References 28 publications

(30 reference statements)

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“…Studies were published between 2009 and 2021, with a total of six prospective studies [ 11 , 23 – 27 ], 34 retrospective studies [ 9 , 10 , 12 , 14 , 15 , 28 – 56 ], and five studies in which the design was not clearly described [ 8 , 13 , 57 – 59 ]. Thirteen studies reported on the learning curve of L-TME [ 10 – 12 , 26 , 27 , 39 – 44 , 58 , 59 ], twenty on the learning curve of R-TME [ 13 – 15 , 23 – 25 , 28 – 35 , 52 – 57 ], eight on the learning curve of TaTME [ 8 , 9 , 36 – 38 , 48 – 50 ], and four reported on the comparison of the learning curve of two approaches [ 45 – 47 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies reported on the learning curve of L-TME [ 10 – 12 , 26 , 27 , 39 – 44 , 58 , 59 ], twenty on the learning curve of R-TME [ 13 – 15 , 23 – 25 , 28 – 35 , 52 – 57 ], eight on the learning curve of TaTME [ 8 , 9 , 36 – 38 , 48 – 50 ], and four reported on the comparison of the learning curve of two approaches [ 45 – 47 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies reported on institutional learning curves [ 8 , 9 , 11 , 13 , 31 – 33 , 39 , 41 – 43 , 49 , 59 ], while the others reported on surgeons’ individual learning curves. Previous experience with colorectal surgery was mentioned in twenty-one studies [ 8 – 10 , 13 , 15 , 24 , 25 , 28 , 29 , 31 , 35 , 37 , 39 – 42 , 45 – 47 , 51 – 56 ]. The majority of studies defined exclusion criteria, while seventeen did not exclude patients during the learning curve [ 8 , 13 , 14 , 23 , 27 , 29 – 32 , 37 , 46 , 48 , 49 , 53 – 57 ].…”

Section: Resultsmentioning

confidence: 99%

“…After establishing a learning curve, 23 studies reported on the comparison of outcomes between patients that had been operated during the learning curve and patients that had been operated after completing the learning curve [ 8 , 9 , 11 , 13 – 15 , 24 , 25 , 29 , 30 , 32 , 35 , 37 , 38 , 43 , 46 , 47 , 51 – 53 , 56 – 58 ]. Bege et al, who used postoperative complications to assess the learning curve, showed a decline in postoperative morbidity after the learning curve for L-TME was reached [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…Rubinkiewicz et al, who used postoperative morbidity, intraoperative morbidity, operative time and a composite outcome to assess the learning curve of TaTME, showed a significant decline in postoperative morbidity and intraoperative morbidity after the learning curve was reached [ 37 ]. Operative times were significantly reduced in thirteen studies after the learning curve was reached [ 8 , 14 , 15 , 24 , 33 , 37 , 38 , 46 , 47 , 51 – 53 , 56 , 57 ] (Table 5 ). Eight of these studies used operative time to assess the learning curve.…”

Section: Resultsmentioning

confidence: 99%

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The learning curve of laparoscopic, robot-assisted and transanal total mesorectal excisions: a systematic review

et al. 2022

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Background The standard treatment of rectal carcinoma is surgical resection according to the total mesorectal excision principle, either by open, laparoscopic, robot-assisted or transanal technique. No clear consensus exists regarding the length of the learning curve for the minimal invasive techniques. This systematic review aims to provide an overview of the current literature regarding the learning curve of minimal invasive TME. Methods A systematic literature search was performed. PubMed, Embase and Cochrane Library were searched for studies with the primary or secondary aim to assess the learning curve of either laparoscopic, robot-assisted or transanal TME for rectal cancer. The primary outcome was length of the learning curve per minimal invasive technique. Descriptive statistics were used to present results and the MINORS tool was used to assess risk of bias. Results 45 studies, with 7562 patients, were included in this systematic review. Length of the learning curve based on intraoperative complications, postoperative complications, pathological outcomes, or a composite endpoint using a risk-adjusted CUSUM analysis was 50 procedures for the laparoscopic technique, 32–75 procedures for the robot-assisted technique and 36–54 procedures for the transanal technique. Due to the low quality of studies and a high level of heterogeneity a meta-analysis could not be performed. Heterogeneity was caused by patient-related factors, surgeon-related factors and differences in statistical methods. Conclusion Current high-quality literature regarding length of the learning curve of minimal invasive TME techniques is scarce. Available literature suggests equal lengths of the learning curves of laparoscopic, robot-assisted and transanal TME. Well-designed studies, using adequate statistical methods are required to properly assess the learning curve, while taking into account patient-related and surgeon-related factors.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The learning curve of laparoscopic, robot-assisted and transanal total mesorectal excisions: a systematic review

et al. 2022

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Emerging multi-port soft tissue robotic systems: a systematic review of clinical outcomes

Leang,

Kong,

Mosharaf

et al. 2024

J Robotic Surg

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Multiple novel multi-port robotic surgical systems have been introduced into clinical practice. This systematic review aims to evaluate the clinical outcomes of these novel robotic systems to conventional laparoscopic technique and established da Vinci robotic surgical platforms. A literature search of Embase, Medline, Pubmed, Cochrane library, and Google Scholar was performed according to the PRISMA guidelines from 2012 to May 2023. Studies comparing clinical outcomes of novel multi-port robotic surgical systems with laparoscopic or the da Vinci platforms were included. Case series with no comparison groups were excluded. Descriptive statistics were used to report patient and outcome data. A systematic narrative review was provided for each outcome. Twelve studies comprised of 1142 patients were included. A total of 6 novel multi-port robotic systems: Micro Hand S, Senhance, Revo-i MSR-5000, KangDuo, Versius, and Hugo™ RAS were compared against the laparoscopic or the da Vinci robotic platforms. Clinical outcomes of these novel robotic platforms were comparable to the established da Vinci platforms. When compared against conventional laparoscopic approaches, the robotic platforms demonstrated lower volume of blood loss, shorter length of stay but longer operative time. This systematic review highlighted the safe implementation and efficacy of 6 new robotic systems. The clinical outcomes achieved by these new robotic systems are comparable to the established da Vinci robotic system in simple to moderate case complexities. There is emerging evidence that these new robotic systems provide a viable alternative to currently available robotic platforms.

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Effects of robotic and laparoscopic-assisted surgery on lymph node dissection and quality of life in the upper third of gastric cancer: A retrospective cohort study based on propensity score matching

Liu

et al. 2023

Front. Surg.

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ObjectiveThe objective of this study was compare the effects of robot-assisted and laparoscopic-assisted surgery on lymph node dissection and quality of life in upper third gastric cancer patients undergoing radical total gastrectomy.MethodsThe clinical and follow-up data of 409 patients with upper third gastric cancer who underwent total gastrectomy from July 2016 to May 2021 were enrolled. The patients were divided into a robotic group (n = 106) and a laparoscopic group (n = 303). Age, sex, body mass index, American Society of Anesthesiologists score, tumor size and location, pathological type, cT, cN, and cTNM were adjusted to offset selection bias. The patient characteristics, operative procedures, surgical outcomes, oncologic and pathologic outcomes, number of lymph node dissections, quality of life assessment, and nutritional status were compared between the two groups.ResultsAfter propensity score matching, 61 cases were included in the robotic group and 122 cases were included in the laparoscopic group. The number of dissected lymph nodes (37.3 ± 13.5 vs. 32.8 ± 11.8, P = 0.022) significantly differed between the two groups. The number of lower mediastinal and subphrenic lymph nodes in the robotic group was greater than that in the laparoscopic group, and the difference was statistically significant (P < 0.001). Compared with the laparoscopic group, the total score of physical symptoms in the robotic group was significantly lower at 6 and 12 months after surgery (P = 0.03 and P = 0.001, respectively). The total social function score at 6 and 12 months after surgery was higher in the robotic group (P = 0.006 and P = 0.022). The quality of life scores were statistically significant only at 3 months after the operation (P = 0.047). A higher patient-generated subjective global assessment (PG-SGA) score is when the score significantly correlated (P < 0.001) with a higher related physical symptoms score, lower social function score, and lower quality of life score.ConclusionCompared with laparoscopic radical gastrectomy, robotic radical gastrectomy is safe and feasible. Compared with laparoscopic radical gastrectomy, robotic radical gastrectomy was more refined, was associated with less surgical bleeding, and increased the quality of lymph node dissection. In addition, patients in the robotic group showed better postoperative quality of life.

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Comparison of the operative outcomes and learning curves between laparoscopic and “Micro Hand S” robot-assisted total mesorectal excision for rectal cancer: a retrospective study

Cited by 4 publications

References 28 publications

The learning curve of laparoscopic, robot-assisted and transanal total mesorectal excisions: a systematic review

The learning curve of laparoscopic, robot-assisted and transanal total mesorectal excisions: a systematic review

Emerging multi-port soft tissue robotic systems: a systematic review of clinical outcomes

Effects of robotic and laparoscopic-assisted surgery on lymph node dissection and quality of life in the upper third of gastric cancer: A retrospective cohort study based on propensity score matching

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