Contemporary minimally invasive surgery for adrenal masses: it's not all about (pure) laparoscopy

Pavan, Nicola; Derweesh, Ithaar; Rassweiler, Jens; Challacombe, Benjamin; Zargar, Homayoun; Porter, James R.; Liatsikos, Evangelos; Kaouk, Jihad; Porpiglia, Francesco; Autorino, Riccardo

doi:10.1111/bju.13701

Cited by 6 publications

(2 citation statements)

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“…[ 3 ] While the technical ease of resection and the surgeon's instrumentation freedom are discussed in detail in many studies, the anesthetic implications, analgesic needs, and patient outcomes are less studied. [ 4 5 6 7 8 9 ] There is a limitation in literature on the superiority of robot-assisted laparoscopy over conventional laparoscopy in postoperative pain in abdominal surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparison of analgesic requirements in robot-assisted versus conventional laparoscopic abdominal surgeries

Mangalath¹,

Kumar²,

Sawant³

et al. 2021

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: Robot-assisted surgery is advantageous in the precision of tissue handling and shorter postoperative recovery. We compared postoperative analgesic requirements in laparoscopic versus robot-assisted surgery in the first 24 h as our primary objective. The secondary outcomes were extubation on table, time to ambulation, and length of ICU stay. Material and Methods: After approval from the ethics committee 48 patients undergoing either laparoscopic (group L [ n = 24]) or robotic abdominal surgery (group R [ n = 24]) were evaluated for analgesic requirements postoperative targeting a numerical rating scale ≤3 in a prospective comparative study. Postoperative patients were allotted to a three-tier pain management, level 1 comprising paracetamol 1 g intravenously every 8 h, level 2, 1.5 mg/kg tramadol every 8 h, and level 3 fentanyl 0.5 μg/kg. The total analgesic consumption in the first 24 h was calculated for each group. Statistical analysis was performed using the Chi-square test and Mann-Whitney U test. Results: Age, weight, and types of surgery were comparable between the groups. The intraoperative opioid use was comparable between both groups but the duration of surgery was longer in group R. Postoperative analgesic requirements were significantly less in group R ( P = 0.024) and the length of ICU stay was shorter ( P < 0.05). The time to ambulation was significantly shorter in group R patients ( P < 0.001). Conclusion: Analgesic requirements were significantly less in robot-assisted laparoscopic surgery in the first 24 h. The time to ambulation and length of ICU stay were shorter in the robot-assisted group in comparison to the laparoscopic group.

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Section: Introductionmentioning

confidence: 99%

Comparison of analgesic requirements in robot-assisted versus conventional laparoscopic abdominal surgeries

Mangalath¹,

Kumar²,

Sawant³

et al. 2021

Journal of Anaesthesiology Clinical Pharmacology

View full text Add to dashboard Cite

show abstract

“…As the role of robotic nephroureterectomy for upper urothelial cancer remains under scrutiny, Veccia et al report a systematic review and meta-analysis of comparative outcomes versus more established nephroureterectomy techniques [22]. Robotic surgery is also being explored for adrenal surgery [23], and Ye et al describe a novel adrenal enucleation technique [24]. Moreover, the robotic platform has allowed to replicate in quality and extent lymph node dissections for several genitourinary cancers [25], and a leader group in the field report one of the largest series of primary robotic retroperitoneal lymph node dissection for non-seminomatous germ cell testicular cancer [26].…”

mentioning

confidence: 99%