Is Robotic Complete Mesocolic Excision Feasible for Transverse Colon Cancer?

Ozben, Volkan; Muijnck, Cansu de; Esen, Eren; Aytaç, Erman; Baca, Bilgi; Karahasanoğlu, Tayfun; Hamzaoğlu, İsmail

doi:10.1089/lap.2018.0239

Cited by 16 publications

(15 citation statements)

References 28 publications

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“…Ozben et al [ 19 ] closed the enterocolotomy in a double layer but they preferred continuous 3/0 V-Loc for the inner layer and interrupted 3/0 silk for the second one. Instead, two manuscripts reported a single layer continuous suture in this phase, without specifying the type of suture [ 21 , 22 ]. Only Blumberg et al [ 20 ] in 2018 closed the defect with another firing of robotic 3.5 mm stapler.…”

Section: Resultsmentioning

confidence: 99%

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Ileo-colic intra-corporeal anastomosis during robotic right colectomy: a systematic literature review and meta-analysis of different techniques

Guadagni

Palmeri

Bianchini

et al. 2021

Int J Colorectal Dis

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Purpose Robotic assistance could increase the rate of ileo-colic intra-corporeal anastomosis (ICA) during robotic right colectomy (RRC). However, although robotic ICA can be accomplished with several different technical variants, it is not clear whether some of these technical details should be preferred. An evaluation of the possible advantage of one respect to another would be useful. Methods We conducted a systematic review of literature on technical details of robotic ileo-colic ICA, from which we performed a meta-analysis of clinical outcomes. The extracted data allowed a comparative analysis regarding the outcome of overall complication (OC), bleeding rate (BR) and leakage rate (LR), between (1) mechanical anastomosis with robotic stapler, versus laparoscopic stapler, versus totally hand-sewn anastomosis and (2) closure of enterocolotomy with manual double layer, versus single layer, versus stapled. Results A total of 30 studies including 2066 patients were selected. Globally, the side-to-side, isoperistaltic anastomosis, realized with laparoscopic staplers, and double-layer closure for enterocolotomy, is the most common technique used. According to the meta-analysis, the use of robotic stapler was significantly associated with a reduction of the BR with respect to mechanical anastomosis with laparoscopic stapler or totally hand-sewn anastomosis. None of the other technical aspects significantly influenced the outcomes. Conclusions ICA fashioning during RRC can be accomplished with several technical variants without evidence of a clear superiority of anyone of these techniques. Although the use of robotic staplers could be associated with some benefits, further studies are necessary to draw conclusions.

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Section: Resultsmentioning

confidence: 99%

“…Eight articles [8,[16][17][18][19][20][21][22] described the use of robotic stapler in fashioning an ileo-colic anastomosis. All the anastomoses were mechanical isoperistaltic.…”

Section: Descriptive Analysismentioning

confidence: 99%

Ileo-colic intra-corporeal anastomosis during robotic right colectomy: a systematic literature review and meta-analysis of different techniques

Guadagni

Palmeri

Bianchini

et al. 2021

Int J Colorectal Dis

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“…Data on robotic technique for diverticulitis are limited. Majority of the series reporting the safety and feasibility of robotic surgery focused on the role for the treatment of colorectal cancer . While robotic surgery offers technical advantages supporting operative dexterity by providing better vision and increased maneuverability, it has still no proven superiority over laparoscopy according to current evidence‐based literature .…”

Section: Discussionmentioning

confidence: 99%

Totally laparoscopic and totally robotic surgery in patients with left‐sided colonic diverticulitis

Bilgin

Bas

Benlice

et al. 2020

Robotics Computer Surgery

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Background: Introduction of the da Vinci Xi system has facilitated the use of robotics in colorectal surgery. Nevertheless, data on the outcomes of robotic surgery for the treatment of colonic diverticulitis have remained scarce. Methods: Patient demographics, clinical characteristics, and perioperative outcomes of the patients undergoing totally robotic with the da Vinci Xi system or laparoscopic surgery for left-sided colonic diverticulitis (LCD) were compared. Results: Laparoscopic and robotic groups included 22 and 20 patients, respectively. There were no significant differences between the two groups in terms of patient demographics, clinical characteristics, operative time, and postoperative complications. There were three conversions in the laparoscopy group and no conversion in the robotic group (P = 0.23). Conversion to open surgery was associated with postoperative morbidity (P = 0.02). Conclusion: Robotic surgery is an applicable alternative for the treatment of LCD. Robotic approach may potentially lower the risk of operative morbidity by reducing the requirement of conversion. K E Y W O R D S colectomy, laparoscopic surgery, left sided colonic diverticulitis, robotic surgery

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“…As in right-sided cancer and opposite to open surgery, a medial-to-lateral approach first accessing the central vasculature has become the standard [17] and is correlated with lower complication rates and shorter OR times and hospital stay. Robotic surgery herein follows the principles of laparoscopic surgery [18], with the bottom-to-up principle gaining popularity due to its better exposure of central structures [13,19].…”

Section: Technical Overview For Cmementioning

confidence: 99%

“…For non-right-sided cancer, two publications exist: one for mesocolic transverse colon resection [31] and one for left-sided mesocolic excision [32]. For carcinoma of the transverse colon, Ozben summarized his experiences in 29 patients of whom 12 patients underwent extended right colectomy, 10 extended left colectomy, 6 subtotal colectomy, and 1 total colectomy [31]. Operations were completed within a mean time of 322 min, postoperative complications were registered in 24% of patients, the rate of patients with complete mesocolic resection was calculated as 79%, there were no conversions.…”

Section: The Authors Finally Concluded That Robotic Surgery For Mesocmentioning

confidence: 99%

Complete mesocolic excision in minimally invasive surgery of colonic cancer: do we need the robot?

et al. 2020

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Summary Background Robotic surgery offers favorable prerequisites for complex minimally invasive surgeries which are delivered by higher degrees of freedom, improved instrument stability, and a perfect visualization in 3D which is fully surgeon controlled. In this article we aim to assess its impact on complete mesocolic excision (CME) in colon cancer and to answer the question of whether the current evidence expresses a need for robotic surgery for this indication. Methods Retrospective analysis and review of the current literature on complete mesocolic excision for colon cancer comparing the outcome after open, laparoscopic, and robotic approaches. Results Complete mesocolic excision results in improved disease-free survival and reduced local recurrence, but turns out to be complex and prone to complications. Introduced in open surgery, the transfer to minimally invasive surgery resulted in comparable results, however, with high conversion rates. In comparison, robotic surgery shows a reduced conversion rate and a tendency toward higher lymph node yield. Data, however, are insufficient and no high-quality studies have been published to date. Almost no oncologic follow-up data are available in the literature. Conclusion The current data do not allow for a reliable conclusion on the need of robotic surgery for CME, but show results which hypothesize an equivalence if not superiority to laparoscopy. Due to recently published technical improvements for robotic CME and supplementary features of this method, we suppose that this approach will gain in importance in the future.

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Is Robotic Complete Mesocolic Excision Feasible for Transverse Colon Cancer?

Abstract: Robotic CME for transverse colon cancer is feasible and can be a procedure of choice to achieve a good surgical quality.

Cited by 16 publications

References 28 publications

Ileo-colic intra-corporeal anastomosis during robotic right colectomy: a systematic literature review and meta-analysis of different techniques

Ileo-colic intra-corporeal anastomosis during robotic right colectomy: a systematic literature review and meta-analysis of different techniques

Totally laparoscopic and totally robotic surgery in patients with left‐sided colonic diverticulitis

Complete mesocolic excision in minimally invasive surgery of colonic cancer: do we need the robot?

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