Current status of robotic training in the UK – a trainees perspective

Chan, Kaite E; Vasdev, Nikhil

doi:10.14319/ijcto.0201.3

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…3 Third, as is the case for robotic surgery in general, robotic PC is associated with a faster postoperative recovery, less postoperative pain and improved post-operative cosmetic appearance. 8,9 This case also demonstrates a good response of UA to chemotherapy, contrary to what has been previously shown. 1,10 Further research is needed to establish the role of adjuvant chemotherapy in treating UA.…”

Section: Discussioncontrasting

confidence: 86%

The role of robotic partial cystectomy in a patient with metastatic primary adenocarcinoma of the bladder

Vasdev

Adshead

2015

Int J Cancer Ther Oncol

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Case Report AbstractTreatment of urachal adenocarcinoma (UA) of the urinary bladder has typically been with radical cystectomy (RC) but more conservative approaches are gaining popularity. Here we present the case of a female patient with metastatic primary bladder UA who was treated with robotic partial cystectomy (RPC) and adjuvant chemotherapy; she is alive with no evidence of disease recurrence or metastatic disease at 5 years. This case provides some of the longest follow-up after RPC to date thereby demonstrating that RPC is a safe and oncologically viable treatment for selected patients even several years after definitive treatment.Patients undergoing RPC benefit from the reduced morbidity associated with this less radical treatment whilst enjoying similarly successful oncological outcomes to RC.

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Section: Discussioncontrasting

confidence: 86%

The role of robotic partial cystectomy in a patient with metastatic primary adenocarcinoma of the bladder

Vasdev

Adshead

2015

Int J Cancer Ther Oncol

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“…3 However, LPN is a technically challenging procedure that requires advanced laparoscopic skills and, in the vast majority of cases, the need for renal hilar occlusion. 4,5,7 In an attempt to shorten the considerable learning curve associated with LPN, to ease surgeon fatigue, and to further expand indications set for LPN, robotic partial nephrectomy (RPN) has been introduced. Outcomes of early experience reports have thus far have been favourable.…”

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confidence: 99%

The results of 2013 survey to evaluate Laparoscopic and Partial nephrectomy practice in the United Kingdom

Vasdev

Mafeld

Fuge

et al. 2014

Int J Cancer Ther Oncol

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EditorialWith the increase of routine ultrasound and cross-sectional imaging there has been an increase in the number of small renal masses worldwide. 1,5 Due to this trend there is migration on the diagnosis of smaller renal masses that localized lesions, which has allowed for urologists to pursue nephron-sparing approaches to treatment, including partial nephrectomy and targeted in situ ablation. 2 Laparoscopic partial nephrectomy (LPN) similarly offers equivalent disease-specific outcomes but with shortened convalescence compared with OPN. 3 However, LPN is a technically challenging procedure that requires advanced laparoscopic skills and, in the vast majority of cases, the need for renal hilar occlusion. 4,5,7 In an attempt to shorten the considerable learning curve associated with LPN, to ease surgeon fatigue, and to further expand indications set for LPN, robotic partial nephrectomy (RPN) has been introduced. Outcomes of early experience reports have thus far have been favourable. 5,6 In the UK there is a variation in the number of LPN and RPN being performed throughout the country. To establish current practice of either technique we developed a questionnaire, which was sent to all Urological cancer units in the UK in March 2013 with a request of all participating urological surgeons to return the survey within 3 months of receipt. Prior to sending the questionnaire each cancer centre was individually telephone by both the first and second authors of this paper. A 73 % response was received from national experts in the UK performing either LPN (Group 1) or RPN (Group 2). All data collected included selection criteria, pre-operative scoring, details of surgical technique, average warm ischemia time and approximate complication rate.The results of the survey indicated that surgeons in Group 1 (LPN) consisted of 19 Surgeons who have performed a total of 465 LPN from June 2002 until November 2012. All surgeons select tumour < 4cm in size which are at least 50 % exophytic. Ten percent of surgeons use the RENAL scorings system. The control of the renal hilum was with the lap bulldog (50 %), lap satinsky (20 %), rummell loop (10 %) and no clamp (10 %). The mean warm ischemia time was 16.6 minutes (Range 0 -30). The mean incidence of urinoma was 2.4 % (Range 2-15), AV Fistula 0.6 % (Range 0 -3) and emergency nephrectomy was 0.5 % (0 -4). Twenty percent of surgeons perform Retroperitoneal LPN.In Group 2 (RPN) there were only 7 surgeons which indicates that RPN is only being performed by a select few centres in the UK and is a relatively new procedure who have performed a total of 227 RPN from January 2008 until November 2012. All surgeons selected tumour < 5 cm which were technically feasible. Fifty seven percent of surgeons use a scorings system i.e. RENAL or PADUA. The mean warm ischemia time was 15.3 minutes (Range 0 -27). The control of the renal hilum was with the lap bulldog (100 %). The mean incidence of urinoma was 1 (Range 0 -5), AV Fistula 0.5 % (Range 0 -5) and emergency nephrectomy was 0. None of su...

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Current status of robotic training in the UK – a trainees perspective

Cited by 2 publications

References 24 publications

The role of robotic partial cystectomy in a patient with metastatic primary adenocarcinoma of the bladder

The role of robotic partial cystectomy in a patient with metastatic primary adenocarcinoma of the bladder

The results of 2013 survey to evaluate Laparoscopic and Partial nephrectomy practice in the United Kingdom

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