Gynaecological robotic surgery at a state hospital — our own experience

Abstract

Objectives: In recent years, the rapid development of minimally invasive surgical methods, including robotic surgery, has resulted in a marked decline of the traditional methods in gynaecological surgery. The aim of the study was to share our experience with robotic surgery at a state hospital. Material and methods: A total of 40 patients, who underwent robotic gynaecological surgery (GS) between 2015 and 2017, were included. Age, BMI, previous abdominal operations (PAO), operation indications (OI), operative time (OT), pathological evaluation, uterine weight (UW), blood loss during surgery (BL), complications, and duration of the hospitalization (DoH) were analyzed. The Da Vinci XI was used during surgery. Results: A total of 40 patients were analyzed. Mean values were as follows: age-48 years, BMI-28, and PAO-12%. The most common OI included uterine fibroids (52%) and abnormal uterine bleeding (45%). Mean OT, docking time and console time values were 166 min, 15 min, and 123 min, respectively. Mean BL was 93 mL. Mean UW was 256 gr, and DoH was 4 days. Perioperative and postoperative complications were observed in 10% and 20% of the cases, respectively. Conclusions: Robotic-assisted surgery is invaluable in gynaecology, especially in the case of endometriosis, extensive adhesion, and in some oncological patients, as it allows for better visualization and higher maneuverability. In order for a surgeon to prepare for such cases, the use of the robot in benign cases is necessary to complete the learning curve and gain speed.

First experience with the Hugo™ robot‐assisted surgery system for endometriosis: A descriptive study

“…The technical setup with the Medtronic Hugo™ RAS system is significantly different from the DaVinci® Surgical System and we explored the consequences of this with three measurements of team performance: ing time was 17 minutes, which is slightly longer than the reported 5-15 minutes for the DaVinci® Surgical System. [20][21][22] One explanation is that different docking setups were used (Figure 1) and since these were the first 12 procedures, the docking of the system had not yet become routine for the surgeons and might be reduced with more procedures. Further, we experienced that the Medtronic Hugo™ RAS system required more personalization according to patient anatomy compared with the DaVinci® Surgical System.…”

Positioning patients for robotic‐assisted surgery: A qualitative study of operating room nurses' experiences

“…RAS is a type of ‘minimally invasive surgery’ where a computer is placed between the surgeon and the patient, and a camera with two ‘eyes’ provides both depth of vision and a stable three‐dimensional picture. The surgeon directs the robotic arms using hand and foot controls on a console but is physically separated from the patient and the surgical team (Kadioglu et al, 2018; Zelhart & Kaiser, 2018). The introduction of RAS has several advantages when compared with conventional surgery.…”