Is Smaller Workspace a Limitation for Robot Performance in Laparoscopy?

Thakre, Atul A.; Bailly, Yannick; Sun, Loi-Wah; Meer, F. Van; Yeung, Chung‐Kwong

doi:10.1016/j.juro.2007.10.091

Cited by 75 publications

(37 citation statements)

References 7 publications

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“…The results described in the literature show similar success as the ''gold standard'' open procedure of around 95% (14)(15)(16)(17)(18)(19)(20) Although we previously presented our early small experience with RAP in infants, and demonstrated all of nine infants 3 to 8 months old successfully underwent RAP, a larger comparison study had been needed to evaluate fully the outcomes of this approach based on patient age (19), because smaller workspace may be a limitation for robotic performance in laparoscopy (21). In addition, robot-assisted laparoscopic "reoperative" pyeloplasty in children with persistent UPJO after open surgical correction is also reported to be a safe and effective option in the treatment of these challenging indications (22,23).…”

Section: Outcomementioning

confidence: 72%

Robotic-Assisted Laparoscopic Surgery in Pediatric Urology: An Update

Casale

Kojima

2009

Scand J Surg

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Laparoscopic procedures for urological diseases in children, such as nephrectomy, pyeloplasty and orchiopexy, have proven to be safe and effective with outcome comparable to the open procedure. However, main drawback has been the relatively steep learning curve for this procedure because of technical difficulties of suturing and anastomosis. More recently, robotic-assisted laparoscopic surgery (RAS) has gained enormous popularity in adult urology and is increasingly being adopted around the world; however, few pediatric urology series have been reported. RAS has several advantages over conventional laparoscopic surgery, with the main advantage being simplification and precision of exposure and suturing because of allowing movements of the robotic arm in real time with increased degree of freedom and magnified 3-dimentional view. These features render RAS ideal for complex reconstructive surgery in a pediatric urological population. This review discusses the role of RAS in pediatric urology, and provides some technical aspects of RAS and a critical summary of current knowledge on its indications and outcome. Almost all operations that are classically performed as open or conventional laparoscopic reconstructive surgery for children with urological anomalies could be replaced by RAS, which may be established as an alternative minimally invasive surgery in the future.

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Section: Outcomementioning

confidence: 72%

Robotic-Assisted Laparoscopic Surgery in Pediatric Urology: An Update

Casale

Kojima

2009

Scand J Surg

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“…In addition to its general advantages, the 3‐D visualization and seven degrees of freedom permit dedicated dissection of the renal pedicle. We preferred to use the 8‐mm articulated instruments instead of 50‐mm instruments, because specific tasks require acute angulations that can be carried out easily only with the 8‐mm instruments; the 5‐mm instruments have joint kinematics that require more space to operate . Indeed, the larger trocar diameter was largely offset by its high maneuverability in tiny volumes.…”

Section: Discussionmentioning

confidence: 99%

Partial nephrectomy for small children: Robot‐assisted versus open surgery

et al. 2017

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“…The minimum increase of IAV for a successful operation was not defined, but the greater is the laparoscopic workspace, the easier it is to perform laparoscopic manipulations. 42 Therefore, it is important to know that some conditions (previous pregnancy or laparoscopic surgery) may be rather protective, whereas others make the patient prone to insufficient laparoscopic workspace.…”

Section: Laparoscopic Workpacementioning

confidence: 99%

Abdominal compliance

Blaser

Björck

Keulenaer

et al. 2015

Journal of Trauma and Acute Care Surgery

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Abdominal compliance (AC) is an important determinant and predictor of available workspace during laparoscopic surgery. Furthermore, critically ill patients with a reduced AC are at an increased risk of developing intra-abdominal hypertension and abdominal compartment syndrome, both of which are associated with high morbidity and mortality. Despite this, AC is a concept that has been neglected in the past.AC is defined as a measure of the ease of abdominal expansion, expressed as a change in intra-abdominal volume (IAV) per change in intra-abdominal pressure (IAP):AC = ΔIAV / ΔIAPAC is a dynamic variable dependent on baseline IAV and IAP as well as abdominal reshaping and stretching capacity. Whereas AC itself can only rarely be measured, it always needs to be considered an important component of IAP. Patients with decreased AC are prone to fulminant development of abdominal compartment syndrome when concomitant risk factors for intra-abdominal hypertension are present.This review aims to clarify the pressure-volume relationship within the abdominal cavity. It highlights how different conditions and pathologies can affect AC and which management strategies could be applied to avoid serious consequences of decreased AC.We have pooled all available human data to calculate AC values in patients acutely and chronically exposed to intra-abdominal hypertension and demonstrated an exponential abdominal pressure-volume relationship. Most importantly, patients with high level of IAP have a reduced AC. In these patients, only small reduction in IAV can significantly increase AC and reduce IAPs.A greater knowledge on AC may help in selecting a better surgical approach and in reducing complications related to intra-abdominal hypertension.

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Is Smaller Workspace a Limitation for Robot Performance in Laparoscopy?

Cited by 75 publications

References 7 publications

Robotic-Assisted Laparoscopic Surgery in Pediatric Urology: An Update

Robotic-Assisted Laparoscopic Surgery in Pediatric Urology: An Update

Partial nephrectomy for small children: Robot‐assisted versus open surgery

Abdominal compliance

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