Da Vinci SP robotic approach to colorectal surgery: two specific indications and short-term results

Piozzi, Guglielmo Niccolò; Kim, Ji-Seon; Choo, Jeong Min; Shin, Seon Hui; Kim, J S; Lee, T-H; Baek, Se Jin; Kwak, Jung‐Myun; Kim, J; Kim, Seon Hahn

doi:10.1007/s10151-022-02597-x

Cited by 20 publications

(13 citation statements)

References 37 publications

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“…Long‐term oncological studies proved the oncological safety of RISR [41]. The novel da Vinci® Single‐Port System (Intuitive Surgical, Sunnyvale, CA, USA) could further facilitate RISR [42–44].…”

Section: Discussionmentioning

confidence: 99%

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International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome

Piozzi

Khobragade

Aliyev³

et al. 2023

Colorectal Disease

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AimIntersphincteric resection (ISR) is an oncologically complex operation for very low‐lying rectal cancers. Yet, definition, anatomical description, operative indications and operative approaches to ISR are not standardized. The aim of this study was to standardize the definition of ISR by reaching international consensus from the experts in the field. This standardization will allow meaningful comparison in the literature in the future.MethodA modified Delphi approach with three rounds of questionnaire was adopted. A total of 29 international experts from 11 countries were recruited for this study. Six domains with a total of 37 statements were examined, including anatomical definition; definition of intersphincteric dissection, intersphincteric resection (ISR) and ultra‐low anterior resection (uLAR); indication for ISR; surgical technique of ISR; specimen description of ISR; and functional outcome assessment protocol.ResultsThree rounds of questionnaire were performed (response rate 100%, 89.6%, 89.6%). Agreement (≥80%) reached standardization on 36 statements.ConclusionThis study provides an international expert consensus‐based definition and standardization of ISR. This is the first study standardizing terminology and definition of deep pelvis/anal canal anatomy from a surgical point of view. Intersphincteric dissection, ISR and uLAR were specifically defined for precise surgical description. Indication for ISR was determined by the rectal tumour's maximal radial infiltration (T stage) below the levator ani. A new surgical definition of T3isp was reached by consensus to define T3 low rectal tumours infiltrating the intersphincteric plane. A practical flowchart for surgical indication for uLAR/ISR/abdominoperineal resection was developed. A standardized ISR surgical technique and functional outcome assessment protocol was defined.

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Section: Discussionmentioning

confidence: 99%

“…RISR was reported to be the most significant parameter for ISR safety of RISR [41]. The novel da Vinci® Single-Port System (Intuitive Surgical, Sunnyvale, CA, USA) could further facilitate RISR [42][43][44].…”

Section: Surgical Technique Of Isrmentioning

confidence: 99%

International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome

Piozzi

Khobragade

Aliyev³

et al. 2023

Colorectal Disease

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“…However, this study was performed on the da Vinci Si ® platform (Intuitive Surgical Inc, Sunnyvale, CA), not on the new da Vinci SP ® robotic system. Only a few papers with a very small number of cases have shown that the new da Vinci SP ® robotic system was safe and feasible for right hemicolectomy 19–21 . However, no studies have compared the new da Vinci SP ® robot with SPL right hemicolectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few papers with a very small number of cases have shown that the new da Vinci SP ® robotic system was safe and feasible for right hemicolectomy. [19][20][21] However, no studies have compared the new da Vinci SP ® robot with SPL right hemicolectomy. Therefore, this study is meaningful in that it included quite a lot of data, with a total of 41 SPR right colectomy cases, and compared SPL and SPR.…”

Section: Discussionmentioning

confidence: 99%

Single‐port laparoscopic versus single‐port robotic right hemicolectomy: Postoperative short‐term outcomes

Lim

Yun

Lee

et al. 2023

Robotics Computer Surgery

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Background: This study aimed to compare the short-term postoperative outcomes of single-port robotic (SPR) using da Vinci SP ® system and single port laparoscopic (SPL) right hemicolectomy and determine whether the novel SPR system is safe and feasible.Methods: From January 2019 to December 2020, a total of 141 patients (41 patients for SPR and 100 patients for SPL) who electively underwent right hemicolectomy for colon cancer performed by a single surgeon were included in the study. Results:The time to the first bowel movement was 3 (range, 1-4) days after surgery in the SPR group and 3 (2-9, range) days in the SPL group (p = 0.017). However, there were no differences in pathologic outcomes or postoperative complications.Conclusions: SPR is a safe and feasible surgical technique and has an advantage in the time to first postoperative bowel movement over SPL with no other complications.

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“…Additionally, the platform's boom can rotate 360°inside and outside the port's remote center, making the performance of multiquadrant surgeries such as colorectal surgery (without having to dock the platform again) possible. Piozzi et al [26] reported the perioperative short-term outcomes of seven intersphincteric resections, five right colectomies, and one transverse colectomy to evaluate the feasibility and safety of the SP system. They described their SP indications as including right-sided colon cancer, ultralow-lying rectal cancer requiring intersphincteric resection, and small or down-sized/ down-staged tumors after preoperative chemoradiation.…”

Section: Sp ⓡ Platformmentioning

confidence: 99%

Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version

Bae

2022

J Anus Rectum Colon

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Robotic surgical systems were created in part to solve several constraints of laparoscopic surgery and offer technical advantages. With a substantial body of evidence that demonstrates its efficacy in the treatment of rectal cancer, robotic surgery will soon become another conventional treatment. However, further investigations and randomized trials focusing on primary endpoints are needed to establish some advantages for robot-assisted colon surgery. Da Vinci Single-Site Ⓡ and SP Ⓡ platforms were developed to overcome the shortcomings of single-port laparoscopic surgery. Despite the currently insufficient evidence, it appears that the SP platform addresses many of the limitations of single-port transabdominal or transanal surgery. Robotic transanal minimally invasive surgery and total mesorectal excision were developed to overcome some of the limitations of conventional platforms, using wristed instrumentation to enhance dexterity and ergonomics. Studies on the effectiveness and viability of this novel approach are ongoing. The near-infrared fluorescence technique, real-time stereotactic navigation technology, and other surgical data platforms based on artificial intelligence incorporated into the robotic system will play an important role in improving outcomes. Robotic systems for advanced colorectal cancer offer technical advantages for complex and precise surgeries. If the cost of robotic surgery is reduced by expanding its indications and enhancing competition among different robotic platforms, it will provide clinical benefits to more patients and reduce social healthcare costs.

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Da Vinci SP robotic approach to colorectal surgery: two specific indications and short-term results

Cited by 20 publications

References 37 publications

International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome

International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome

Single‐port laparoscopic versus single‐port robotic right hemicolectomy: Postoperative short‐term outcomes

Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version

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